Individual
DR. SAMIR M. KOUSSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4725 N. FEDERAL HIGHWAY, FORT LAUDERDALE, FL 33308-4603
(954) 771-8000
(954) 776-3270
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME 74360
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050063733
RAILROAD MEDICARE
FL
05
—
254031200
—
FL
01
—
285354
AVMED
FL
01
—
44428
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/12/2006
Last updated
08/28/2012
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