Individual
NOUHAD YACOUB MOUSSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3301 W GANDY BLVD, TAMPA, FL 33611-2931
(813) 925-1903
Mailing address
PO BOX 64568, PHOENIX, AZ 85082-4568
(318) 424-5449
(855) 230-1466
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME68141
FL
208000000X
Pediatrics Physician
ME68141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101288
AMERIGROUP
FL
01
—
26902
BLUE CROSS OF FLORIDA
FL
05
—
377492900
—
FL
Enumeration date
06/11/2006
Last updated
06/24/2019
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