Healthcare Provider Details

I. General information

NPI: 1932112521
Provider Name (Legal Business Name): MAJD ALSAMMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 HARBOR BLVD
PORT CHARLOTTE FL
33952-5000
US

IV. Provider business mailing address

713 E MARION AVE SUITE 121
PUNTA GORDA FL
33950-3872
US

V. Phone/Fax

Practice location:
  • Phone: 941-766-4125
  • Fax: 941-766-4101
Mailing address:
  • Phone: 941-833-1750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME77574
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: