Provider Demographics
NPI:1619371556
Name:MUSMAR, SAMAR
Entity Type:Individual
Prefix:DR
First Name:SAMAR
Middle Name:
Last Name:MUSMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:SAMAR
Other - Middle Name:
Other - Last Name:GHAZAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:305-628-6117
Mailing Address - Fax:
Practice Address - Street 1:3128 E HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610
Practice Address - Country:US
Practice Address - Phone:813-579-1767
Practice Address - Fax:813-305-7907
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65237207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine