Provider Demographics
NPI:1730671298
Name:HAMMOUDA, AMR YOUSSRY (MBBCH)
Entity Type:Individual
Prefix:
First Name:AMR
Middle Name:YOUSSRY
Last Name:HAMMOUDA
Suffix:
Gender:M
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF FLORIDA PEDIATRIC RESIDENCY
Mailing Address - Street 2:5153 NORTH 9TH AVE, 6TH FLOOR NEMOURS
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504
Mailing Address - Country:US
Mailing Address - Phone:850-416-7658
Mailing Address - Fax:
Practice Address - Street 1:COMMUNITY HEALTH NORTHWEST FLORIDA
Practice Address - Street 2:1295 W. FAIRFIELD DRIVE
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501
Practice Address - Country:US
Practice Address - Phone:850-941-7841
Practice Address - Fax:850-332-0155
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN26077390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program