MEDICARE: OUSSAMA HAJAL PA

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	363AM0700X	Medical Physician Assistant	PA2384	NV
2	363A00000X	Physician Assistant	PA2384	NV

General Provider Information

NPI Number	:	1811585730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OUSSAMA HAJAL PA

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4469 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1605
Country	:	US
Telephone Number	:	702-637-4239
Fax Number	:	877-569-2931

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

Provider Enumeration Date	:	01/06/2021
Last Update Date	:	03/04/2026

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Directions to “ OUSSAMA HAJAL PA” Practice Location

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