Provider Demographics
NPI:1376733147
Name:OSMAN, NAELA GHASSAN (MD)
Entity Type:Individual
Prefix:
First Name:NAELA
Middle Name:GHASSAN
Last Name:OSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAELA
Other - Middle Name:GHASSAN
Other - Last Name:EL-OSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PHYSICIAN ASSOCIATES LLC
Mailing Address - Street 2:PO BOX 522468
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32752-2468
Mailing Address - Country:US
Mailing Address - Phone:407-804-5379
Mailing Address - Fax:407-804-5398
Practice Address - Street 1:PHYSICIAN ASSOCIATES LLC
Practice Address - Street 2:3400 QUADRANGLE BOULEVARD
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817
Practice Address - Country:US
Practice Address - Phone:407-384-1030
Practice Address - Fax:407-275-9937
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97613208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
BO7994862OtherDEA CERTIFICATION