Individual
DR. AZZAM MUFTAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15205 CORTEZ BLVD, BROOKSVILLE, FL 34613-6072
(352) 597-7744
(352) 597-7797
Mailing address
5350 SPRING HILL DR, SPRING HILL, FL 34606-4562
(352) 277-5348
(352) 606-2857
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME68485
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100014202
MEDICARE RAILROAD
FL
01
—
16328
WELLCARE
FL
01
—
219941
AVMED
FL
05
—
250149000
—
FL
01
—
28978
BLUE CROSS BLUE SHIELD
FL
01
—
5825117
AETNA
FL
01
—
593570847
PROVIDER ID
FL
01
—
6013192
GHI
FL
Enumeration date
03/31/2006
Last updated
04/08/2026
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