Healthcare Provider Details

I. General information

NPI: 1447201538
Provider Name (Legal Business Name): KHALID ABUSAADA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 03/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE SUITE 235
ORLANDO FL
32804-4603
US

IV. Provider business mailing address

PO BOX 918025
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5138
  • Fax: 352-273-5213
Mailing address:
  • Phone: 352-273-5138
  • Fax: 352-273-5213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME95355
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME95355
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: