Healthcare Provider Details

I. General information

NPI: 1396249835
Provider Name (Legal Business Name): AMIR ABASS TOURAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MORRIS ST STE 300
CHARLESTON WV
25301-1853
US

IV. Provider business mailing address

6850 LAKE NONA BLVD
ORLANDO FL
32827-7408
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-6441
  • Fax:
Mailing address:
  • Phone: 407-266-1106
  • Fax: 407-266-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number33029
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: