Individual provider Active NPI

Gabriel Bizouati, M.D.

  • Internal Medicine Physician
  • North Miami Beach, FL
National Provider Identifier
1548414121
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME39988 Issued in FL
Practice address
743 NE 167TH St
North Miami Beach, FL 33162-2404
Phone
(305) 597-0017
Fax
(786) 629-3922
NPI assigned
Nov 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME39988 FL Primary
Cardiovascular Disease Physician 207RC0000X ME39988 FL

Addresses

Primary practice location

743 NE 167TH St
North Miami Beach, FL 33162-2404

Mailing address

6100 Blue Lagoon Dr Ste 365
Miami, FL 33126-7010
Phone (786) 322-7333

Other identifiers 1

IdentifierTypeStateIssuer
114624700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621000631 FL Practitioner - Family PracticePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8820073281 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME39988FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Alliance LLC Internal Medicine CurrentSince Dec 10, 2023 Accepting new patients
Access Medical Group of North Miami Beach, LLC. Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients
Mel-Bay Health Care Inc Family Medicine Past Accepting new patients

Locations

4729 US Highway 98 S
Ste 201
Lakeland, FL 33812
Phone (863) 646-9663

4725 US Highway 98 S
Ste 101
Lakeland, FL 33812
Phone (863) 646-9663

6100 Blue Lagoon Dr
Ste 365
Miami, FL 33126
Phone (786) 322-7333

743 NE 167th St
North Miami Beach, FL 33162
Phone (305) 597-0017

6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJGBDA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1548414121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 365",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331267010",
            "telephone_number": "786-322-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 NE 167TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331622404",
            "telephone_number": "305-597-0017",
            "fax_number": "786-629-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIZOUATI",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-10",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME39988",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME39988",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114624700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.