Healthcare Provider Details

I. General information

NPI: 1508956715
Provider Name (Legal Business Name): AMAL A MASRI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 NW 167TH ST
NORTH MIAMI BEACH FL
33169-6017
US

IV. Provider business mailing address

16800 NW 2ND AVE STE 309
NORTH MIAMI BEACH FL
33169-5508
US

V. Phone/Fax

Practice location:
  • Phone: 305-654-7753
  • Fax: 305-673-9259
Mailing address:
  • Phone: 305-654-7753
  • Fax: 305-673-9259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO2553
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: