Healthcare Provider Details

I. General information

NPI: 1922390988
Provider Name (Legal Business Name): HUMAM SAMIR ALABSI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 W ALEXANDER ST
PLANT CITY FL
33563-7116
US

IV. Provider business mailing address

905 FRANKLIN ST
WATERLOO IA
50703-4407
US

V. Phone/Fax

Practice location:
  • Phone: 863-284-5000
  • Fax: 863-284-1916
Mailing address:
  • Phone: 319-874-3000
  • Fax: 319-874-3411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR-8868
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-41511
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME152590
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: