Individual provider · Type 1 NPI

Rose Ibrahim

Surgical Physician Assistant · Orlando, FL

NPI number 1902576150 Active

Practice location

125 W Copeland Dr
Orlando, FL 32806-2101

Call (321) 841-7090 Map

Fax (321) 843-2267

Other practice locations

  • 360 Huntington Avenue, 202 Robinson Hall/pa Program, Boston, MA 02115 · (617) 373-3195

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA9089 (MA)
Surgical Physician Assistant Primary 363AS0400XPA9119022 (FL)
Physician Assistant 363A00000XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1902576150

Rose Ibrahim's National Provider Identifier is 1902576150, issued on Sep 19, 2021. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Orlando, FL. The record was last updated on Oct 16, 2024.