Provider Demographics
NPI:1619549698
Name:YOUSIF, BEDRI M (MD)
Entity Type:Individual
Prefix:
First Name:BEDRI
Middle Name:M
Last Name:YOUSIF
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 1:29129 BAY HOLLOW DR APT 3204
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-4350
Mailing Address - Country:US
Mailing Address - Phone:813-370-8009
Mailing Address - Fax:
Practice Address - Street 1:29129 BAY HOLLOW DR APT 3204
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-4350
Practice Address - Country:US
Practice Address - Phone:813-370-8009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-11
Last Update Date:2021-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42203207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology