1649374950 NPI number — DR. MANUEL E BABAIAN MD

Table of content: DR. MANUEL E BABAIAN MD (NPI 1649374950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649374950 NPI number — DR. MANUEL E BABAIAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BABAIAN
Provider First Name:
MANUEL
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649374950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 667111
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POMPANO BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33066
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-784-3131
Provider Business Mailing Address Fax Number:
954-900-2900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5700 N FEDERAL HWY #1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-784-3131
Provider Business Practice Location Address Fax Number:
954-900-2900
Provider Enumeration Date:
09/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  ME73318 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 252568200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 235910 . This is a "AVMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 25962 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41408 . This is a "BC BS PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1032627 . This is a "CAREPLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: G22675 . This is a "VISTA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2595699 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000771 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007169400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com