Provider Demographics
NPI:1649374950
Name:BABAIAN, MANUEL E (MD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:E
Last Name:BABAIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 667111
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33066
Mailing Address - Country:US
Mailing Address - Phone:954-784-3131
Mailing Address - Fax:954-900-2900
Practice Address - Street 1:5700 N FEDERAL HWY #1
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-784-3131
Practice Address - Fax:954-900-2900
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73318207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252568200Medicaid
235910OtherAVMED
25962OtherNEIGHBORHOOD HEALTH
41408OtherBC BS PPO
1032627OtherCAREPLUS
G22675OtherVISTA
2595699OtherAETNA
1000771OtherHUMANA
G22675Medicare UPIN