Provider Demographics
NPI:1699974915
Name:FUTURE MEDICAL ASSOCIATES INC
Entity type:Organization
Organization Name:FUTURE MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDEL-AZIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAYOUMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-215-3001
Mailing Address - Street 1:PO BOX 2098
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-0050
Mailing Address - Country:US
Mailing Address - Phone:850-215-3001
Mailing Address - Fax:850-215-3668
Practice Address - Street 1:509 E 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-5307
Practice Address - Country:US
Practice Address - Phone:850-215-3001
Practice Address - Fax:850-215-3668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 99491261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03055OtherBLUE CROSS
FL279435700Medicaid
FL279435700Medicaid