Provider Demographics
NPI:1427374354
Name:KOUKA, NABEEL (MD, DO, MBA, MPH)
Entity Type:Individual
Prefix:DR
First Name:NABEEL
Middle Name:
Last Name:KOUKA
Suffix:
Gender:M
Credentials:MD, DO, MBA, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 E HALLANDALE BEACH BLVD STE 705
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4725
Mailing Address - Country:US
Mailing Address - Phone:305-280-0505
Mailing Address - Fax:305-280-0599
Practice Address - Street 1:1920 E HALLANDALE BEACH BLVD STE 705
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4725
Practice Address - Country:US
Practice Address - Phone:305-280-0505
Practice Address - Fax:305-280-0599
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255543204D00000X
FLOS 10968204D00000X, 204D00000X
FLOS10968207QS0010X, 207QS0010X, 207Q00000X
PAOS 14994207QS0010X
TNDO 2101207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine