Organization
MASOUD KETABCHI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASOUD KETABCHI MD (PRESIDENT)
(305) 654-5037
Entity
Organization
Contact information
Practice address
160 NW 170 ST, PARKWAY REGIONAL MEDICAL CENTER, NORTH MIAMI BEACH, FL 33162
(305) 654-5037
(305) 654-5237
Mailing address
PO BOX 025483, MIAMI, FL 33102
(305) 654-5037
(305) 654-5237
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21598
BLUE CROSS BLUE SHIELD
FL
05
—
253463100
—
FL
Enumeration date
05/06/2006
Last updated
06/04/2010
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