Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | ME 0070490 | FL |
NPI | 1205936770 |
---|---|
Provider Name | Dr. Youssef W. Wassef |
First Address | Gainesville, FL 32635-8492 |
Second Address | Gainesville, FL 32605-4269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 26/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
267792000 | (05) | FL |
51651 | BLUE CROSS BLUE SHIELD ID (01) | FL |
51651Z | (05) | FL |
G 30381 | (02) |