Provider Demographics
NPI:1427091727
Name:SIOUFI, M FIRAS (MD)
Entity type:Individual
Prefix:
First Name:M
Middle Name:FIRAS
Last Name:SIOUFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W COLONIAL DR STE 488
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3436
Mailing Address - Country:US
Mailing Address - Phone:407-296-1910
Mailing Address - Fax:407-253-2644
Practice Address - Street 1:10000 W COLONIAL DR STE 488
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3436
Practice Address - Country:US
Practice Address - Phone:407-296-1910
Practice Address - Fax:407-253-2644
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4284432084N0400X
FLME1023872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001037100Medicaid
FL79633OtherBCBS
FLBT676WMedicare UPIN
FL79633OtherBCBS
FLBT676VMedicare UPIN