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NPI Code Detail

MEDICARE: SAFA O ALBASSAM CRNA

MEDICARE: SAFA O ALBASSAM CRNA
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
1367500000XCertified Registered Nurse AnesthetistARNP9253629FL
2367500000XCertified Registered Nurse Anesthetist1229379TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447639299
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAFA O ALBASSAM CRNA
Provider Business Mailing Address
First Line : 3601 W COMMERCIAL BLVD STE 5
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33309-3392
Country : US
Telephone Number : 954-703-2931
Fax Number : 954-585-9207
Provider Business Practice Location Address
First Line : 12222 MERIT DR STE 600
Second Line :
City : DALLAS
State : TX
Zip : 75251-3294
Country : US
Telephone Number : 972-715-5000
Fax Number : 972-715-9976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2015
Last Update Date : 06/04/2026

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Directions to “ SAFA O ALBASSAM CRNA” Practice Location

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