Provider Demographics
NPI:1629040787
Name:MASRI, MOHAMMAD MILHIM (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:MILHIM
Last Name:MASRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MOHAMMAD
Other - Middle Name:MILHIM
Other - Last Name:MASRI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 432300
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33243-2300
Mailing Address - Country:US
Mailing Address - Phone:305-328-8537
Mailing Address - Fax:305-726-0019
Practice Address - Street 1:6140 SW 70TH ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3419
Practice Address - Country:US
Practice Address - Phone:305-328-8537
Practice Address - Fax:305-726-0019
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME000456732086X0206X
FLME456732086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048253600Medicaid
FL1629040787Medicare Oscar/Certification
FL05831WMedicare PIN