Provider Demographics
NPI:1346261468
Name:AMAWI, FIRAS BASSAM (DO)
Entity Type:Individual
Prefix:DR
First Name:FIRAS
Middle Name:BASSAM
Last Name:AMAWI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1106 BEL AIRE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-3637
Mailing Address - Country:US
Mailing Address - Phone:386-257-3269
Mailing Address - Fax:386-257-9880
Practice Address - Street 1:315 NORTH LAKEMONT AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3205
Practice Address - Country:US
Practice Address - Phone:407-647-2550
Practice Address - Fax:407-647-0616
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMA122703207Q00000X
FLOS8008207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH77373Medicare UPIN
NM343405501Medicare ID - Type Unspecified
FLH77373Medicare UPIN