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General NPI Number Information
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NPI Number | 1780635557
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Entity Type | Organization
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Legal Business Name | OMAR DAVID HUSSAMY MD PA
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 1717 INDIAN RIVER BLVD STE 202B
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City | VERO BEACH
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State | FL
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Zip | 32960-0864
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Country | US
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Telephone | 772-213-9800
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Fax | 772-213-9810
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Provider Business Mailing Address
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Address Line | PO BOX 643408
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City | VERO BEACH
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State | FL
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Zip | 32964-3408
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Country | US
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Telephone | 772-213-9800
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Fax | 772-213-9810
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MICHELLE CLOUGH
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Credential |
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Telephone | 772-213-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME65456
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License Number State | FL
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