Provider Demographics
NPI:1619249364
Name:YOUAKIM, MAURICE ISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:ISSA
Last Name:YOUAKIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 LACERA DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4009
Mailing Address - Country:US
Mailing Address - Phone:813-932-3894
Mailing Address - Fax:813-931-7424
Practice Address - Street 1:10505 LACERA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4009
Practice Address - Country:US
Practice Address - Phone:813-932-3894
Practice Address - Fax:813-931-7424
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL18691207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology