Healthcare Provider Details

I. General information

NPI: 1619914868
Provider Name (Legal Business Name): BELAYET HOSSAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/10/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 S CONGRESS AVE # 204
ATLANTIS FL
33462-6635
US

IV. Provider business mailing address

PO BOX 266211
WESTON FL
33326-6211
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-4118
  • Fax: 561-967-3463
Mailing address:
  • Phone: 567-967-4115
  • Fax: 561-967-3463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME79044
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME79044
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME79044
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: