| Organization Name: | BAHJAT F GHANEM MD PA |
| NPI Number: | 1326077116 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BAHJAT F GHANEM (PRESIDENT) |
| Mailing Address: | 1800 W 49th St Suite 114 Hialeah |
| State: | FL US |
| Postal Code: | 330122900 |
| Phone Number: | 3058225964 |
| Fax Number: | 3058220058 |
| NPI Enumeration Date: | 07/02/2006 |
| NPI Last Update Date: | 11/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0066087 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |