Healthcare Provider Details

I. General information

NPI: 1942167697
Provider Name (Legal Business Name): PREMIER INFECTIOUS DISEASE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 PINE RIDGE RD
NAPLES FL
34119-3900
US

IV. Provider business mailing address

2338 IMMOKALEE RD STE 186
NAPLES FL
34110-1445
US

V. Phone/Fax

Practice location:
  • Phone: 239-330-2933
  • Fax:
Mailing address:
  • Phone: 239-330-2933
  • Fax: 833-249-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: OMAR HUSSAIN
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 240-461-0661