Provider Demographics
NPI:1114149481
Name:M. NAZIR HAMOUI MD
Entity Type:Organization
Organization Name:M. NAZIR HAMOUI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:M.
Authorized Official - Middle Name:NAZIR
Authorized Official - Last Name:HAMOUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-596-1101
Mailing Address - Street 1:12900 CORTEZ BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613
Mailing Address - Country:US
Mailing Address - Phone:352-596-1101
Mailing Address - Fax:352-596-7869
Practice Address - Street 1:12900 CORTEZ BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613
Practice Address - Country:US
Practice Address - Phone:352-596-1101
Practice Address - Fax:352-596-7869
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M. NAZIR HAMOUI MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-03
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0034613208800000X
FLME34613208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0589700001OtherNSC
FL0589700001Medicare NSC
FL0589700001OtherNSC