MEDICARE: DR. HADEEL ABUMUNSHAR DMD

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	122300000X	Dentist	DN29595	FL

General Provider Information

NPI Number	:	1700677879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HADEEL ABUMUNSHAR DMD

Provider Business Mailing Address
First Line	:	1654 RUSHES AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-2957
Country	:	US
Telephone Number	:	224-623-9958
Fax Number	:

Provider Business Practice Location Address
First Line	:	3518 E 15TH ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32404-5831
Country	:	US
Telephone Number	:	224-623-9958
Fax Number	:

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

Provider Enumeration Date	:	05/16/2025
Last Update Date	:	05/16/2025

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