# BAHJAT F GHANEM MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326077116
- **Authorized official:** DR. BAHJAT F GHANEM MD (PRESIDENT)
- **Authorized official phone:** (305) 822-5964

## Contact information

- **Practice address:** 1800 W 49TH ST, SUITE 114, HIALEAH, FL 33012-2900
- **Practice address phone:** (305) 822-5964
- **Practice address fax:** (305) 822-0058
- **Mailing address:** 1800 W 49TH ST, SUITE 114, HIALEAH, FL 33012-2900
- **Mailing address phone:** (305) 822-5964
- **Mailing address fax:** (305) 822-0058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 0066087 | FL | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 11/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 373630000 | — | FL |