MEDICARE: AMAL MASRI DPM 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	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

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

General Provider Information

NPI Number	:	1912572405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAL MASRI DPM PA

Provider Business Mailing Address
First Line	:	16800 NW 2ND AVE STE 309
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33169-5508
Country	:	US
Telephone Number	:	305-654-7753
Fax Number	:

Provider Business Practice Location Address
First Line	:	16800 NW 2ND AVE STE 309
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33169-5508
Country	:	US
Telephone Number	:	305-654-7753
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMAL A MASRI
Credential	:	DPM
Telephone Number	:	305-654-7753

Provider Enumeration Date	:	05/26/2021
Last Update Date	:	09/10/2021

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Directions to “AMAL MASRI DPM PA ” Practice Location

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