MEDICARE: LALLA IHSSAN TOUHAMI EL OUAZZANI

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
1	225100000X	Physical Therapist	PT31929	FL

General Provider Information

NPI Number	:	1386194009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LALLA IHSSAN TOUHAMI EL OUAZZANI

Provider Business Mailing Address
First Line	:	2117 LAKE PICKETT RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32826-4949
Country	:	US
Telephone Number	:	407-580-4226
Fax Number	:

Provider Business Practice Location Address
First Line	:	2117 LAKE PICKETT RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32826-4949
Country	:	US
Telephone Number	:	407-580-4226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2016
Last Update Date	:	01/15/2017

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