Provider Demographics
NPI:1952370769
Name:RASSAM, AMER GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:AMER
Middle Name:GEORGE
Last Name:RASSAM
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 1:1653 MAHAN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5454
Mailing Address - Country:US
Mailing Address - Phone:850-219-8000
Mailing Address - Fax:850-219-8003
Practice Address - Street 1:1653 MAHAN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5454
Practice Address - Country:US
Practice Address - Phone:850-219-8000
Practice Address - Fax:850-219-8003
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93572174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273931300Medicaid
FL273931300Medicaid
FL30598ZMedicare PIN