Provider Demographics
NPI:1790860310
Name:GHITIS, ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:GHITIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NW 84TH AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1817
Mailing Address - Country:US
Mailing Address - Phone:954-731-1101
Mailing Address - Fax:954-915-1129
Practice Address - Street 1:350 NW 84TH AVE
Practice Address - Street 2:STE 300
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1817
Practice Address - Country:US
Practice Address - Phone:954-731-1101
Practice Address - Fax:954-915-1129
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61904207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372810200Medicaid
FL372810200Medicaid
FL372810200Medicaid