Healthcare Provider Details
I. General information
NPI: 1972646495
Provider Name (Legal Business Name): SOBIA NAJM MASOUD M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/15/2007
Last Update Date: 04/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2940 IMMOKALEE RD SUITE 2
NAPLES FL
34110-1409
US
IV. Provider business mailing address
1735 TRIANGLE PALM TER
NAPLES FL
34119-3396
US
V. Phone/Fax
- Phone: 239-598-5750
- Fax: 239-593-1989
- Phone: 239-595-2456
- Fax: 239-593-1989
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME97959 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: