Provider Demographics
NPI:1386982213
Name:WEHBE, MOHAMMAD ALI (PA-C)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:ALI
Last Name:WEHBE
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 1:3139 MILLWOOD TER APT M227
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-3820
Mailing Address - Country:US
Mailing Address - Phone:954-829-8681
Mailing Address - Fax:
Practice Address - Street 1:11657 SW ROWENA ST
Practice Address - Street 2:
Practice Address - City:POST SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:33498
Practice Address - Country:US
Practice Address - Phone:954-829-8681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant