Healthcare Provider Details

I. General information

NPI: 1447393251
Provider Name (Legal Business Name): ANDLEEB ANWAR USMANI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

V. Phone/Fax

Practice location:
  • Phone: 305-668-5518
  • Fax: 305-668-5579
Mailing address:
  • Phone: 305-668-5518
  • Fax: 305-668-5579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberOS9945
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS9945
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: