Individual
DR. WISSAM MOHAMED ELFALLAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
305 MEMORIAL MEDICAL PKWY STE 505, DAYTONA BEACH, FL 32117-5170
(386) 231-3540
(386) 231-3544
Mailing address
PO BOX 863381, ORLANDO, FL 32886-3381
(386) 231-3249
(386) 672-9904
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
5101021284
MI
207T00000X
Neurological Surgery Physician
Primary
OS17401
FL
Other
Enumeration date
06/26/2014
Last updated
08/18/2021
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