Individual
OMAIMA MOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8880 NAVARRE PKWY STE 102, NAVARRE, FL 32566-3613
(850) 939-5550
(850) 939-5445
Mailing address
8880 NAVARRE PKWY STE 102, NAVARRE, FL 32566-3613
(850) 939-5550
(850) 939-5445
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ME87566
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268996100
—
FL
01
—
591-68789
BLUE CROSS BLUE SHIELD OF ALABAM
AL
01
—
81080
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
06/23/2006
Last updated
05/08/2008
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