Individual
DR. MAZEN DAOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12580 UNIVERSITY DR, SUITE 200, FORT MYERS, FL 33907-5686
(239) 274-0005
(239) 274-8185
Mailing address
12580 UNIVERSITY DR, SUITE 200, FORT MYERS, FL 33907-5686
(239) 274-0005
(239) 274-8185
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
ME81133
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-00804
UNITED HEALTHCARE PROVIDE
FL
01
—
06492
BCBS PROVIDER #
FL
01
—
202599
WELLCARE PROVIDER #
FL
01
—
2821758
AVMED PROVIDER #
FL
01
—
70017117
RR MEDICARE PROVIDER #
FL
Enumeration date
04/25/2006
Last updated
02/27/2009
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