MEDICARE: DR. MOUSSA SISSOKO MD

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	207RH0003X	Hematology & Oncology Physician	2024-02971	NC
2	207RH0003X	Hematology & Oncology Physician	176905	FL

General Provider Information

NPI Number	:	1669679809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOUSSA SISSOKO MD

Provider Business Mailing Address
First Line	:	3555 10TH CT
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5013
Country	:	US
Telephone Number	:	772-563-4673
Fax Number	:

Provider Business Practice Location Address
First Line	:	3555 10TH CT
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5013
Country	:	US
Telephone Number	:	772-563-4673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	01/07/2026

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