Provider Demographics
NPI:1972646495
Name:NAJM MASOUD, SOBIA (MD)
Entity Type:Individual
Prefix:
First Name:SOBIA
Middle Name:
Last Name:NAJM MASOUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 TRIANGLE PALM TER
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3396
Mailing Address - Country:US
Mailing Address - Phone:239-595-2456
Mailing Address - Fax:239-593-1989
Practice Address - Street 1:2940 IMMOKALEE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1409
Practice Address - Country:US
Practice Address - Phone:239-598-5750
Practice Address - Fax:239-593-1989
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97959208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278433500Medicaid