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General NPI Number Information
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NPI Number | 1306360474
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Entity Type | Individual
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Provider Name | ALI MOUZANNAR MD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 1150 NW 14TH ST STE 309
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City | MIAMI
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State | FL
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Zip | 33136-2114
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Country | US
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Telephone | 305-243-6090
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 SALZEDO ST APT 1110
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City | CORAL GABLES
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State | FL
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Zip | 33134-4348
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Country | US
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Telephone | 786-676-1151
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME169743
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License Number State | FL
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