Ghata, Ghassan J

Ghata, Ghassan J is an sole proprietor health care provider with primary practice located at 13770 Beach Blvd Suit 6, Jacksonville FL 32224-7205. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Ghata, Ghassan J can be contacted via phone (904) 330-0524.

Contact Information

Primary practice address
13770 Beach Blvd Suit 6 Jacksonville FL 32224-7205
Phone: (904) 330-0524
Fax: (904) 647-9491
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X ME0026102 Florida
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME0026102 Florida

Profile Details

NPI number 1013983063
LBN Legal business name Ghata, Ghassan J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 28th, 2006
Last updated May 13th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013983063 NPPES
Florida MEDICAID 099154500

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