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General NPI Number Information
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NPI Number | 1023984564
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Entity Type | Individual
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Provider Name | ISMAEL ABUSAMRA
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Gender |
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 3300 S UNIVERSITY DR
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City | FT LAUDERDALE
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State | FL
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Zip | 33328-2004
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Country | US
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Telephone | 571-331-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 387 NE 191ST ST APT 103
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City | MIAMI
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State | FL
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Zip | 33179-5533
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 48264
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License Number State | FL
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