Individual
DR. JIMMY S GHOSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DABR, FRCPC
Contact information
Practice address
20900 BISCAYNE BLVD, AVENTURA, FL 33180-1407
(305) 682-7000
Mailing address
PO BOX 7623, NAPLES, FL 34101-7623
(305) 712-7229
(305) 397-1139
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
042.0011875
VT
2085N0700X
Neuroradiology Physician
Primary
ME148543
FL
2085R0202X
Diagnostic Radiology Physician
ME148543
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110014300
—
FL
01
—
14959853
CAQH
FL
01
—
NM590
FLORIDA MEDICARE
FL
01
—
OTFV9
FLORIDA BCBS
FL
01
—
Q00222986
RAILROAD MEDICARE
FL
Enumeration date
03/21/2007
Last updated
07/05/2022
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