| Samar Fawaz, | |
|
175 Villa Nueva Ave Ne, Palm Bay, FL 32907-2595 | |
| (313) 574-2965 | |
| (321) 603-3560 |
| Full Name | Samar Fawaz |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 175 Villa Nueva Ave Ne, Palm Bay, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548779580 | NPI | - | NPPES |
| P02091188 | Other | FL | RRMEDICARE PTAN |
| 101048700 | Medicaid | FL | |
| JL436Z | Other | FL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 5601008292 (Michigan) | Secondary |
| 363A00000X | Physician Assistant | PA9111341 (Florida) | Primary |
| Entity Name | Henry Ford Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811073901 PECOS PAC ID: 0547178311 Enrollment ID: O20031210001052 |
| Mailing Address | Practice Location Address |
|---|---|
| Samar Fawaz, 2065 Highway A1a Apt 1403, Indian Harbour Beach, FL 32937-1811 Ph: (313) 574-2965 | Samar Fawaz, 175 Villa Nueva Ave Ne, Palm Bay, FL 32907-2595 Ph: (313) 574-2965 |
Ms. Jeanette Marie Gluck, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5070 Minton Rd Nw Ste 3, Palm Bay, FL 32907 Phone: 321-768-1600 Fax: 321-255-2361 |
Karen Paz, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 20 San Filippo Dr Se, Palm Bay, FL 32909 Phone: 321-725-8300 Fax: 321-725-1555 |
Garion Rivera, Physician Assistant Medicare: Medicare Enrolled Practice Location: 1841 Sandia Rd Se, Palm Bay, FL 32909 Phone: 423-902-5520 |
Mrs. Jessica Regan, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905 Phone: 321-241-6800 Fax: 321-241-6890 |
Nichole M Palomba, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 5070 Minton Rd Nw Ste 3, Palm Bay, FL 32907 Phone: 321-768-1600 Fax: 321-799-4903 |
Maria L Fortington, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907 Phone: 321-768-1600 Fax: 321-799-4903 |
Mrs. Christi Anna Asper, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1421 Malabar Rd Ne Ste 201, Palm Bay, FL 32907 Phone: 321-434-8531 Fax: 321-434-8533 |