Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | ME94732 | FL |
NPI | 1013979566 |
---|---|
Provider Name | Dr. Firas R Muwalla |
First Address | Rockledge, FL 32955-4306 |
Second Address | Merritt Island, FL 32952-3114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 27/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
274921100 | (05) | FL |
37011X | FL MEDICARE (01) | FL |
H07062 | (02) |