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HASIB IBNERASA M.D.

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1821056516

Individual Registrant:
 HASIB  IBNERASA M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2500 W LAKE MARY BLVD SUITE 101 LAKE MARY, FL 32746-3501 US
Tel: 407-936-0976  Fax: 407-936-0977

Contact information for business:
PO BOX 953457  LAKE MARY, FL 32795-3457 US
Tel: 407-936-0976  Fax: 407-936-0977

Registration Information:
NPI: 1821056516
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
FLME76638

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
262539300FL05




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