Provider Demographics
NPI:1881002889
Name:GOBRIAL, GEORGE FAM HAKIM (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:FAM HAKIM
Last Name:GOBRIAL
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 1:601 OAK COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6620
Mailing Address - Country:US
Mailing Address - Phone:407-846-0626
Mailing Address - Fax:407-846-2524
Practice Address - Street 1:601 OAK COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6620
Practice Address - Country:US
Practice Address - Phone:407-846-0626
Practice Address - Fax:407-846-2524
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME148519207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME148519OtherMEDICAL LICENSE