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NPI Code Detail

MEDICARE: FIRAS MADBAK M.D.

MEDICARE: FIRAS MADBAK 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
12086S0102XSurgical Critical Care PhysicianME129969FL

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 : 1710150669
Entity Type Code : Individual
Provider Name (Legal Business Name) : FIRAS MADBAK M.D.
Provider Business Mailing Address
First Line : PO BOX 2147
Second Line :
City : FORT MYERS
State : FL
Zip : 33902-2147
Country : US
Telephone Number : 239-343-1612
Fax Number : 239-343-4229
Provider Business Practice Location Address
First Line : 13685 DOCTORS WAY STE 100
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4337
Country : US
Telephone Number : 239-343-1612
Fax Number : 239-343-4229
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2008
Last Update Date : 03/27/2024

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Directions to “ FIRAS MADBAK M.D.” Practice Location

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