Organization
BAHTA AND ASSOCIATES INC
Active
Organization
BAHTA AND ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRENE FADULLON BAHTA MD (PRESIDENT)
(954) 392-5696
Entity
Organization
Contact information
Practice address
10794 PINES BLVD STE 203, PEMBROKE PINES, FL 33026-3920
(954) 392-5696
(954) 392-5668
Mailing address
PO BOX 260101, PEMBROKE PINES, FL 33026-7101
(954) 392-5696
(954) 392-5668
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
06/04/2007
Last updated
12/06/2010
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