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NPI Code Detail

MEDICARE: MOURAD ABOUELLEIL M.D.

MEDICARE:   MOURAD  ABOUELLEIL  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianME127355FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1208800000XOTHERFLROCKLEDGE HMA
2ME127355OTHERFLFL MEDICAL LICENSE
3208800000XOTHERFLTAXONOMY

General Provider Information

NPI Number : 1225357973
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOURAD ABOUELLEIL M.D.
Provider Business Mailing Address
First Line : PO BOX 20800
Second Line :
City : BELFAST
State : ME
Zip : 04915-4105
Country : US
Telephone Number : 888-902-1099
Fax Number : 888-402-7256
Provider Business Practice Location Address
First Line : 1411 N FLAGLER DR STE 3800
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33401-3426
Country : US
Telephone Number : 561-291-7182
Fax Number : 561-437-2755
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2010
Last Update Date : 10/15/2024

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