DR. AZZAM MUFTAH (NPI# 1417918988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417918988 |
| Entity Type | Individual |
| Full Name | DR. AZZAM MUFTAH |
| Credential | M.D. |
| Practice Address |
12900 Cortez Blvd Suite 203 Brooksville FL 34613-4898 |
| Practice Telephone | 3525977744 |
| Practice Fax Number | 3525977797 |
| Mailing Telephone | 3525977744 |
| Mailing Fax Number | 3525977797 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
ME68485 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | WELLCARE | 16328 | 01 |
| FL | AVMED | 219941 | 01 |
| FL | MEDICARE RAILROAD | 100014202 | 01 |
| FL | AETNA | 5825117 | 01 |
| FL | BLUE CROSS BLUE SHIELD | 28978 | 01 |
| FL | PROVIDER ID | 593570847 | 01 |
| FL | 250149000 | 05 | |
| FL | GHI | 6013192 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 17222 Hospital Blvd Ste 302, Brooksville, FL 346018925 | 3522775397 | 3526160914 |
| Street Address |
12900 CORTEZ BLVD SUITE 203 |
| City | BROOKSVILLE |
| State | FL |
| Zip Code | 34613-4898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023080629 | Hernando Medical Inc | Internal Medicine | 12900 Cortez Blvd, Ste 202, Brooksville, FL 34613 | 2006-02-07 |
| 1285055442 | Ocala Oncology Center Pl | Pathology | 12900 Cortez Blvd, Suite 101, Brooksville, FL 34613-6828 | 2013-12-13 |
| 1154762177 | Paradigm Dental | Dentist | 12900 Cortez Blvd, Ste 201, Brooksville, FL 34613 | 2013-07-08 |
| 1912262601 | Thelma Teresa Nelson | Nurse Practitioner | 12900 Cortez Blvd, Suite 203, Brooksville, FL 34613-6828 | 2012-07-09 |
| 1962777664 | Jay N Rayan, Md | Legal Medicine | 12900 Cortez Blvd, Brooksville, FL 34613-6828 | 2012-03-13 |
| 1114235389 | Hernando Skin & Cancer Center P.a. | Dermatology | 12900 Cortez Blvd, Suite 205, Brooksville, FL 34613-6828 | 2010-09-21 |
| 1548589930 | Scott Michael Edwards | Physician Assistant | 12900 Cortez Blvd, Suite 205, Brooksville, FL 34613-6828 | 2010-05-25 |
| 1235383647 | Tabitha E Muchler | Nurse Practitioner | 12900 Cortez Blvd, Suite 203, Brooksville, FL 34613-6828 | 2008-11-12 |
| 1114149481 | M. Nazir Hamoui Md | Urology | 12900 Cortez Blvd, Suite 101, Brooksville, FL 34613 | 2007-05-03 |
| 1346375839 | Azzam Muftah Md Pa | Specialist | 12900 Cortez Blvd, Suite 203, Brooksville, FL 34613-4898 | 2007-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679196836 | Izza Bazigh | Student in an Organized Health Care Education/Training Program | 11375 Cortez Boulevard, Sr 50, Office of Graduate Medic, Brooksville, FL 34613 | 2020-05-22 |
| 1003446824 | Spring Hill Pediatric Dentistry, LLC | Dentist | 7140 Sagheer St., Brooksville, FL 34613 | 2020-01-21 |
| 1407405822 | Medical Risk Solutions | Family Medicine | 12080 Cortez Blvd, Brooksville, FL 34613 | 2019-09-09 |
| 1528529245 | Edward Joseph Waseleski Jr. | Student in an Organized Health Care Education/Training Program | 11375 Cortez Blvd., State Road 50, Brooksville, FL 34613 | 2019-03-26 |
| 1366903213 | Paresh Rangani | Student in an Organized Health Care Education/Training Program | 11375 Cortez Blvd., State Road 50, Brooksville, FL 34613 | 2019-03-25 |
| 1225558034 | Whitney King | Student in an Organized Health Care Education/Training Program | 11375 Cortez Boulevard, State Road 50, Brooksville, FL 34613 | 2017-06-22 |
| 1922450022 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 13217 Cortez Rd, Brooksville, FL 34613 | 2016-07-13 |
| 1992157408 | Arushi Goel | Internal Medicine | 11375 Cortez Boulevard, Oak Hill Hospital, Brooksville, FL 34613 | 2016-07-08 |
| 1366823122 | Monicka Stella Felix | Internal Medicine | 11375 Cortez Boulevard, Sr 50, Oak Hill Hospital, Gme Attn: Melissa Tammaro, Brooksville, FL 34613 | 2015-06-17 |
| 1790171700 | April Greer | Hearing Instrument Specialist | 13013 Cortez Blvd., Brooksville, FL 34613 | 2015-04-07 |
| Find all providers in zip 34613 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285900670 | Rami Abboud | Internal Medicine | 12900 Cortez Blvd Ste 203, Brooksville, FL 34613-4898 | 2012-03-29 |
| 1417275595 | Shawkat Kero Md Pa | Internal Medicine | 11373 Cortez Blvd Ste 401, Brooksville, FL 34613-5406 | 2010-05-13 |
| 1629182365 | Syed T Bin-sagheer | Internal Medicine | 17222 Hospital Blvd Ste 318, Brooksville, FL 34601-8925 | 2006-08-19 |
| 1356322325 | Pudichery Kunjavara Paul | Internal Medicine | 705 Harvard St, Brooksville, FL 34601-2842 | 2005-11-08 |
| 1932106929 | Shawkat H. Kero | Internal Medicine | 11373 Cortez Blvd #401, Brooksville, FL 34613 | 2005-07-05 |
| 1801940242 | Christopher D Packey | Internal Medicine | 12190 Cortez Blvd, Brooksville, FL 34613-5578 | 2007-01-23 |
| 1235246240 | Premier Gastroenterology Pa | Internal Medicine | 14540 Cortez Blvd, Ste 120, Brooksville, FL 34613-6002 | 2006-08-24 |
| 1922041284 | Husam E Shuayb | Internal Medicine | 11373 Cortez Blvd, Suite 306, Brooksville, FL 34613-5414 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321382 | Charlotte Harbor Gastroenterology LLC | Internal Medicine | 2811 Tamiami Trl Ste I, Port Charlotte, FL 33952-5135 | 2020-09-22 |
| 1750907614 | Michael G. Valladares D.o. P.a. | Internal Medicine | 10302 Sw 116th St, Miami, FL 33176-4049 | 2020-06-17 |
| 1578100996 | Alex Aziz Al Khoury | Internal Medicine | 1120 Nw 14th St. Suite 1112, Miami, FL 33136 | 2019-12-04 |
| 1750922399 | Gastroenterology Care Specialists, LLC | Internal Medicine | 550 Redstone Ave W Ste 430, Crestview, FL 32536-6457 | 2019-10-04 |
| 1194375378 | Digestive and Liver Disease Institute of Florida, LLC | Internal Medicine | 505 W Oak St Ste 202, Kissimmee, FL 34741-4986 | 2019-09-18 |
| 1659833002 | Steven L Diamond | Internal Medicine | 5606 Vintage Oaks Terrace, Delray Beach, FL 33484 | 2019-04-04 |
| 1225507601 | Linmec Corp | Internal Medicine | 4531 Deleon St Ste 215, Fort Myers, FL 33907-1279 | 2018-11-15 |
| 1912474156 | Eileen E Kim | Internal Medicine | 5117 Fiorella Ln, Sanford, FL 32771-5449 | 2018-10-25 |
| 1790251197 | Gabriel Benitez | Internal Medicine | 2330 Wilton Dr, Wilton Manors, FL 33305-1249 | 2018-10-23 |
| 1043786833 | Union Medical Group | Internal Medicine | 6300 Corporate Ct Ste 105, Fort Myers, FL 33919-3513 | 2018-10-18 |
| Find all providers with the same taxonomy | ||||
| City | BROOKSVILLE |
| Zip Code | 34613 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.