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Individual

MR. FOUAD SAM MOURSI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1514 1ST ST N, WINTER HAVEN, FL 33881-2476
(866) 234-8534
Mailing address
47 5TH ST NW, WINTER HAVEN, FL 33881-4672

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
22415
PR
207Q00000X
Family Medicine Physician
22415
PR
208D00000X
General Practice Physician
Primary
ACN1397
FL

Other

Enumeration date
07/12/2017
Last updated
03/17/2022
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