Individual
DR. FAKHIR F. ELMASRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1305 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4542
(863) 688-2334
Mailing address
2115 CRYSTAL GROVE DR, LAKELAND, FL 33801-6875
(863) 688-2334
(863) 577-0301
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME87990
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME87990
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267349500
—
FL
01
—
82394
BCBS
FL
Enumeration date
11/03/2005
Last updated
01/02/2024
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