Provider Demographics
NPI:1609062082
Name:ALL PHYSICAL MEDICINE & REHABILITATION, P.A.
Entity Type:Organization
Organization Name:ALL PHYSICAL MEDICINE & REHABILITATION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSSEF
Authorized Official - Middle Name:W
Authorized Official - Last Name:WASSEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:352-367-3422
Mailing Address - Street 1:PO BOX 358492
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-8492
Mailing Address - Country:US
Mailing Address - Phone:352-367-3422
Mailing Address - Fax:352-379-7707
Practice Address - Street 1:6801 NW 9TH BLVD
Practice Address - Street 2:SUITE # 4
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4269
Practice Address - Country:US
Practice Address - Phone:352-367-3422
Practice Address - Fax:352-379-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 704902081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51651ZMedicaid
FL267792000Medicaid
FL51651OtherBC/BS ID
FL51651OtherBC/BS ID
FLK4629Medicare PIN