| Osama Shuaib Ismail Md Llc | |
|
110 E Byrd Ave Bonifay FL 32425-3004 | |
| (850) 547-2305 | |
| Not Available |
| Full Name | Osama Shuaib Ismail Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 E Byrd Ave, Bonifay, Florida |
| Authorized Official Name and Position | Osama Shuaib Ismail (OWNER) |
| Authorized Official Contact | 8503193361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Osama Shuaib Ismail Md Llc 110 E Byrd Ave Bonifay FL 32425-3004 Ph: () - | Osama Shuaib Ismail Md Llc 110 E Byrd Ave Bonifay FL 32425-3004 Ph: (850) 547-2305 |
| NPI Number | 1912764788 |
|---|---|
| Provider Enumeration Date | 02/28/2024 |
| Last Update Date | 04/24/2024 |
| Medicare PECOS PAC ID | 3678956778 |
|---|---|
| Medicare Enrollment ID | O20220823002528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912764788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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