Provider Demographics
NPI:1811159494
Name:YOUSIF, REMONE THARWAT (MD)
Entity type:Individual
Prefix:
First Name:REMONE
Middle Name:THARWAT
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:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-3492
Mailing Address - Fax:239-424-4030
Practice Address - Street 1:650 DEL PRADO BLVD S STE 106
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-5617
Practice Address - Country:US
Practice Address - Phone:239-424-3492
Practice Address - Fax:239-424-4030
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139440207LP2900X
PAMD446854207LP2900X
OH35.122920208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102346900Medicaid