Organization · NPI-2

Brian B Ibrahim MD PA

Family Medicine · Hollywood, FL

NPI number1073897195
StatusActive
Last updated in NPPESOct 7, 2011

Details

NPI
1073897195
Entity type
Organization (NPI-2)
Legal business name
Brian B Ibrahim MD PA
Organization subpart
No
Enumeration date
Oct 7, 2011
Last updated
Oct 7, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

4200 Washington St
Hollywood, FL 33021-7353

Phone 954-981-6300

Mailing address

2950 Ne 188th St
#311
Aventura, FL 33180-2708

Phone 954-647-2326

Authorized official

Brian B Ibrahim
President
9546472326

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