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Issa F Baroudi

Specialist

Other Service Providers

3222 Tamiami Trl, Port Charlotte, FL 33952-8048

PECOS Enrollment

This provider is enrolled in PECOS as ISSA BAROUDI.

Based on the most recent information from CMS, provider Issa F Baroudi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:30 PM.

Profile Details

Provider ID
1558303966
Provider Type
Individual
Full Name
Baroudi, Issa F
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/11/2006
Last Updated
10/6/2011

Contact Information

Practice Location

3222 Tamiami Trl, Port Charlotte, FL 33952-8048

(941) 627-5155

Unlisted Fax

Mailing Location

3222 Tamiami Trl, Port Charlotte, FL 33952-8048

(941) 627-5155

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License ME38318 Florida

Issa F Baroudi

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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