| Brian B Ibrahim Md Pa | |
|
4200 Washington St Hollywood FL 33021-7353 | |
| (954) 981-6300 | |
| Not Available |
| Full Name | Brian B Ibrahim Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4200 Washington St, Hollywood, Florida |
| Authorized Official Name and Position | Brian B Ibrahim (PRESIDENT) |
| Authorized Official Contact | 9546472326 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian B Ibrahim Md Pa 2950 Ne 188th St #311 Aventura FL 33180-2708 Ph: (954) 647-2326 | Brian B Ibrahim Md Pa 4200 Washington St Hollywood FL 33021-7353 Ph: (954) 981-6300 |
| NPI Number | 1073897195 |
|---|---|
| Provider Enumeration Date | 10/07/2011 |
| Last Update Date | 10/07/2011 |
| Medicare PECOS PAC ID | 4981878246 |
|---|---|
| Medicare Enrollment ID | O20111122000822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073897195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Brian B Ibrahim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891006490 PECOS PAC ID: 8729104708 Enrollment ID: I20100928000093 |
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