Healthcare Provider Details

I. General information

NPI: 1174483606
Provider Name (Legal Business Name): RIM YOUSSEF PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 N ORLANDO AVE STE 201
WINTER PARK FL
32789-2213
US

IV. Provider business mailing address

1035 N ORLANDO AVE STE 201
WINTER PARK FL
32789-2213
US

V. Phone/Fax

Practice location:
  • Phone: 407-678-3255
  • Fax:
Mailing address:
  • Phone: 407-678-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9121024
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: