Provider Demographics
NPI:1316466246
Name:YOUSEF, HAKEEM (PA-C)
Entity type:Individual
Prefix:
First Name:HAKEEM
Middle Name:
Last Name:YOUSEF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 SE 18TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8211
Mailing Address - Country:US
Mailing Address - Phone:352-622-3360
Mailing Address - Fax:352-629-4512
Practice Address - Street 1:1901 SE 18TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8211
Practice Address - Country:US
Practice Address - Phone:352-622-3360
Practice Address - Fax:352-629-4512
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110654363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022482900Medicaid
FLO0UBWOtherBLUE CROSS BLUE SHIELD