Individual
DR. HAZEM MAHMOUD SAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13241 BARTRAM PARK BLVD UNIT 1505, JACKSONVILLE, FL 32258-5231
(904) 374-6899
(904) 503-0039
Mailing address
13241 BARTRAM PARK BLVD UNIT 1505, JACKSONVILLE, FL 32258-5231
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD426523
PA
207W00000X
Ophthalmology Physician
ME105047
FL
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
ME105047
FL
207WX0109X
Neuro-ophthalmology Physician
Primary
ME105047
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101294355
—
PA
Enumeration date
02/22/2006
Last updated
04/19/2019
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