Provider Demographics
NPI:1407041064
Name:MAHER AYOUBI
Entity Type:Organization
Organization Name:MAHER AYOUBI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-769-1766
Mailing Address - Street 1:801 E 6TH ST
Mailing Address - Street 2:SUITE 602
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-3661
Mailing Address - Country:US
Mailing Address - Phone:850-769-1766
Mailing Address - Fax:850-769-9794
Practice Address - Street 1:801 E 6TH ST
Practice Address - Street 2:SUITE 602
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3661
Practice Address - Country:US
Practice Address - Phone:850-769-1766
Practice Address - Fax:850-769-9794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064935207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1187OtherMEDICARE GROUP BILLING #
FL23299ZOtherMEDICARE PROVIDER #
FLK1187OtherMEDICARE GROUP BILLING #