Provider Demographics
NPI:1770558553
Name:BARAKAT, AHMAD B (MD)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:B
Last Name:BARAKAT
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 1:5555 PONCE DE LEON BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2513
Mailing Address - Country:US
Mailing Address - Phone:305-243-7900
Mailing Address - Fax:305-689-0927
Practice Address - Street 1:5555 PONCE DE LEON BLVD STE 115
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2513
Practice Address - Country:US
Practice Address - Phone:305-243-7900
Practice Address - Fax:305-689-0927
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME171448207R00000X
KS04-44632207R00000X, 208M00000X
NC9701241207R00000X
SD76934208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891102LMedicaid
NC1102LOtherBLUECROSS BLUESHIELD
NC2247584CMedicare PIN
G63300Medicare UPIN