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NPI Code Detail

MEDICARE: DR. ALI MOUZANNAR MD

MEDICARE: DR. ALI MOUZANNAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianME169743FL

General Provider Information

NPI Number : 1306360474
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALI MOUZANNAR MD
Provider Business Mailing Address
First Line : 2000 SALZEDO ST APT 1110
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4348
Country : US
Telephone Number : 786-676-1151
Fax Number :
Provider Business Practice Location Address
First Line : 1150 NW 14TH ST STE 309
Second Line :
City : MIAMI
State : FL
Zip : 33136-2114
Country : US
Telephone Number : 305-243-6090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2017
Last Update Date : 03/17/2025

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Directions to “ DR. ALI MOUZANNAR MD” Practice Location

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