Provider Demographics
NPI:1720575137
Name:GHARIB, MOHAMED A (MD)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:A
Last Name:GHARIB
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 1:2726 WINDGUARD CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7361
Mailing Address - Country:US
Mailing Address - Phone:813-907-6774
Mailing Address - Fax:813-907-9022
Practice Address - Street 1:2726 WINDGUARD CIR STE 102
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7361
Practice Address - Country:US
Practice Address - Phone:813-907-6774
Practice Address - Fax:813-907-9022
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146656207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine