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General NPI Number Information
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NPI Number | 1114025301
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Entity Type | Individual
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Provider Name | FARIS M. AL-MOUSILY MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1222 S ORANGE AVE FL 2
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City | ORLANDO
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State | FL
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Zip | 32806-1215
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Country | US
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Telephone | 407-649-6907
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Fax | 407-481-2035
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Provider Business Mailing Address
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Address Line | 3021 W EAU GALLIE BLVD STE 101
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City | MELBOURNE
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State | FL
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Zip | 32934-7005
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Country | US
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Telephone | 321-275-5444
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Fax | 321-275-3799
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | ME70809
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License Number State | FL
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