Provider Demographics
NPI:1942473343
Name:CHEHAB, MOSBAH A (MD)
Entity Type:Individual
Prefix:
First Name:MOSBAH
Middle Name:A
Last Name:CHEHAB
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 1:10041 PINES BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6170
Mailing Address - Country:US
Mailing Address - Phone:954-830-1333
Mailing Address - Fax:954-499-2804
Practice Address - Street 1:9700 SW 114TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-4144
Practice Address - Country:US
Practice Address - Phone:786-547-9884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99646207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME99646OtherLICENSE