MR. HALEEM JACOB MOUSSA (NPI# 1417050386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417050386 |
| Entity Type | Individual |
| Full Name | MR. HALEEM JACOB MOUSSA |
| Credential | CRNA |
| Practice Address |
619 South Marion Ave Lake City FL 32025 |
| Mailing Address |
481 Sw Ridgeview Lane Lake City LA 32024 |
| Practice Telephone | 3867553016 |
| Practice Fax Number | 3867546348 |
| Mailing Telephone | 3867583076 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
R14403 | ND | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | RN, APRN, CRNA | R14403 | 01 |
| Street Address |
619 SOUTH MARION AVE |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164417895 | Charles Holloway Boardman Iv | Occupational Therapist | 619 South Marion Ave, North Florida / South Georgia Veterans Health System, Lake City, FL 32025 | 2005-09-19 |
| 1649303124 | Ann M Barber | Internal Medicine | 619 South Marion Ave, Vamc - Lake City, Lake City, FL 32025-5808 | 2007-03-13 |
| 1114028909 | Eunice Luvis | Pharmacist | 619 South Marion Ave, Lake City, FL 32025 | 2006-09-26 |
| 1528169372 | Eddie James Hukle | Pharmacist | 619 South Marion Ave, Lake City, FL 32056-9000 | 2006-09-26 |
| 1184639981 | Kathleen Erina Mcnamara | Emergency Medicine | 619 South Marion Ave, Lake City, FL 32025 | 2006-07-30 |
| 1497719983 | Raul Edgardo Medina | Family Medicine | 619 South Marion Ave, Va Hospital, Lake City, FL 32025 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 163WM0705X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Medical-Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609053917 | Karyne Williams | Registered Nurse | 619 S Marion Ave, Lake City, FL 32025-5808 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063010395 | Rocio Taveras | Registered Nurse | 7110 Nw 45th St, Coral Springs, FL 33065-2120 | 2020-10-09 |
| 1245845189 | Haydee Melendez | Registered Nurse | 4740 Nw 102nd Ave Apt 107, Doral, FL 33178-2231 | 2020-09-08 |
| 1538778527 | Olamide O Borisade | Registered Nurse | 4870 Deer Lake Dr E Ste 1114, Jacksonville, FL 32246-6301 | 2020-07-27 |
| 1457969339 | Annelise Eugene | Registered Nurse | 1546 Nw 167th Ave, Pembroke Pines, FL 33028-1371 | 2020-07-16 |
| 1639797426 | Alexandra Rachel Castillo | Registered Nurse | 455 Sw 200th Ter, Pembroke Pines, FL 33029-1247 | 2020-07-08 |
| 1477199552 | Arlene Quevedo | Registered Nurse | 471 Arbor Lakes Dr, Davenport, FL 33896-8196 | 2019-11-22 |
| 1326683731 | Desirae Marie Ackerman | Registered Nurse | 3310 Bermuda Isle Cir Apt 222, Naples, FL 34109-2644 | 2019-11-08 |
| 1467094516 | Sonia Findlator | Registered Nurse | 432 Los Altos Way Apt 102, Altamonte Springs, FL 32714-3280 | 2019-10-10 |
| 1235771288 | Jose Gabriel Valdes | Registered Nurse | 8821 W Flagler St Apt 202, Miami, FL 33174-2423 | 2019-10-10 |
| 1598306029 | Melissa Pierre | Registered Nurse | 7711 Sw 8th St, North Lauderdale, FL 33068-2224 | 2019-10-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.