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General NPI Number Information
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NPI Number | 1649443383
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Entity Type | Organization
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Legal Business Name | HOSSAM IBRAHIM MD PLLC
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 8839 BRYAN DAIRY RD SUITE110
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City | LARGO
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State | FL
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Zip | 33777-1201
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Country | US
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Telephone | 727-216-8025
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Fax | 727-230-0693
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Provider Business Mailing Address
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Address Line | 8839 BRYAN DAIRY RD SUITE110
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City | LARGO
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State | FL
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Zip | 33777-1201
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Country | US
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Telephone | 727-216-8025
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Fax | 727-230-0693
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | NAGWA MALEK
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Credential |
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Telephone | 727-218-8025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME58202
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License Number State | FL
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