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NPI Code Detail

MEDICARE: RANA ABUSOUFEH M.D

MEDICARE: RANA ABUSOUFEH 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
12084N0400XNeurology Physician306414LA
22084N0400XNeurology PhysicianME156903FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477997492
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANA ABUSOUFEH M.D
Provider Business Mailing Address
First Line : PO BOX 935921
Second Line :
City : ATLANTA
State : GA
Zip : 31193-5921
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 742 W PLYMOUTH AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-3282
Country : US
Telephone Number : 386-736-8622
Fax Number : 386-738-7629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2013
Last Update Date : 11/01/2024

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Directions to “ RANA ABUSOUFEH M.D” Practice Location

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