| Fawaz Medical And Surgical Clinic, Llc | |
|
962 Us Highway 331 S Defuniak Springs FL 32435-3372 | |
| (850) 951-8800 | |
| Not Available |
| Full Name | Fawaz Medical And Surgical Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 962 Us Highway 331 S, Defuniak Springs, Florida |
| Authorized Official Name and Position | Janna Mauldin (OFFICE MANAGER) |
| Authorized Official Contact | 8509518800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fawaz Medical And Surgical Clinic, Llc 962 Us Highway 331 S Defuniak Springs FL 32435-3372 Ph: (850) 951-8800 | Fawaz Medical And Surgical Clinic, Llc 962 Us Highway 331 S Defuniak Springs FL 32435-3372 Ph: (850) 951-8800 |
| NPI Number | 1801207626 |
|---|---|
| Provider Enumeration Date | 05/14/2014 |
| Last Update Date | 05/14/2014 |
| Medicare PECOS PAC ID | 3476776055 |
|---|---|
| Medicare Enrollment ID | O20140529001116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801207626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | ME82523 (ZZ) | Primary |
| Provider Name | Fawzi Fawaz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932283389 PECOS PAC ID: 0244291664 Enrollment ID: I20041020000123 |
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