Provider Demographics
NPI:1487711180
Name:JOHN K. HAIRABET, M.D., INC.
Entity type:Organization
Organization Name:JOHN K. HAIRABET, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAIRABET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-393-9985
Mailing Address - Street 1:925 S FEDERAL HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6122
Mailing Address - Country:US
Mailing Address - Phone:561-393-9985
Mailing Address - Fax:561-393-3667
Practice Address - Street 1:925 S FEDERAL HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6122
Practice Address - Country:US
Practice Address - Phone:561-393-9985
Practice Address - Fax:561-393-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8704Medicare ID - Type Unspecified
FLD87543Medicare UPIN