MEDICARE: NABIL S. ITANI DO PA

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
1	207R00000X	Internal Medicine Physician	OS9008	FL

General Provider Information

NPI Number	:	1427247451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NABIL S. ITANI DO PA

Provider Business Mailing Address
First Line	:	875 CENTURY MEDICAL DR
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32796-2142
Country	:	US
Telephone Number	:	321-268-8787
Fax Number	:	321-383-2424

Provider Business Practice Location Address
First Line	:	875 CENTURY MEDICAL DR
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32796-2142
Country	:	US
Telephone Number	:	321-268-8787
Fax Number	:	321-383-2424

Authorized Official
Title or Position	:	OWNER
Name	:	NABIL S ITANI
Credential	:	DO
Telephone Number	:	321-795-5223

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	06/24/2026

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Directions to “NABIL S. ITANI DO PA ” Practice Location

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