Koussa, Samir M.

Koussa, Samir M. is an individual health care provider with primary practice located at 4725 N. Federal Highway , Fort Lauderdale FL 33308-4603. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Koussa, Samir M. can be contacted via phone (954) 771-8000.

Contact Information

Primary practice address
4725 N. Federal Highway Fort Lauderdale FL 33308-4603
Phone: (954) 771-8000
Fax: (954) 776-3270
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X ME 74360 Florida

Profile Details

NPI number 1558340067
LBN Legal business name Koussa, Samir M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2006
Last updated Aug 28th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558340067 NPPES
Florida MEDICAID 254031200
Florida Other 44428
Florida Other 44428
Florida Other 285354
Florida Other 050063733

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