Healthcare Provider Details

I. General information

NPI: 1891304192
Provider Name (Legal Business Name): NADEEM HUSSAIN MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 03/23/2025
Certification Date: 03/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 OLD HIGHWAY 441 S STE 105
MOUNT DORA FL
32757-7039
US

IV. Provider business mailing address

1601 JOHNS LAKE RD APT 715
CLERMONT FL
34711-6662
US

V. Phone/Fax

Practice location:
  • Phone: 855-496-4964
  • Fax:
Mailing address:
  • Phone: 520-351-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberR78109
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberBP10086147
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME167106
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: