Individual
HASAN M. MOUSLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 CARLTON AVE, SUITE 1300, LAKE WALES, FL 33853-4348
(863) 676-6386
(863) 676-6452
Mailing address
1120 CARLTON AVE, SUITE 1300, LAKE WALES, FL 33853-4348
(863) 676-6386
(863) 676-6452
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME97722
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277700200
—
FL
01
—
92669
BCBS
FL
Enumeration date
07/06/2005
Last updated
09/20/2012
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