Healthcare Provider Details

I. General information

NPI: 1821714395
Provider Name (Legal Business Name): MENES UNION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 01/22/2023
Certification Date: 01/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 WILES RD STE 201
COCONUT CREEK FL
33073-3414
US

IV. Provider business mailing address

845 W PLANTATION CIR
PLANTATION FL
33324-1420
US

V. Phone/Fax

Practice location:
  • Phone: 954-943-1133
  • Fax: 954-783-6845
Mailing address:
  • Phone: 813-541-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HUSSEIN KALAHY OSMAN MOHAMED
Title or Position: OWNER
Credential: MD
Phone: 813-541-1201