Healthcare Provider Details

I. General information

NPI: 1407296239
Provider Name (Legal Business Name): TARIK M. HUSAIN, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 NW 82ND AVE STE 201
DORAL FL
33166-6662
US

IV. Provider business mailing address

3650 NW 82ND AVE STE 201
DORAL FL
33166-6662
US

V. Phone/Fax

Practice location:
  • Phone: 305-537-7272
  • Fax: 305-537-7274
Mailing address:
  • Phone: 305-537-7272
  • Fax: 305-537-7274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME115417
License Number StateFL

VIII. Authorized Official

Name: TARIK MUHAMMAD HUSAIN
Title or Position: OWNER
Credential: MD
Phone: 305-537-7272