Provider Demographics
NPI:1215167440
Name:ALSAMARAH, ALI (MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:ALSAMARAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:YOUSEF
Other - Last Name:ALSAMARAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1720 SE 16TH AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4620
Mailing Address - Country:US
Mailing Address - Phone:352-369-0288
Mailing Address - Fax:352-867-1053
Practice Address - Street 1:1720 SE 16TH AVE STE 303
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4620
Practice Address - Country:US
Practice Address - Phone:352-369-0288
Practice Address - Fax:352-867-1053
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA266100207RC0000X
FLME151414207RC0000X, 207RI0011X
AZ46022208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110116606AMedicaid
FL010390700Medicaid