Healthcare Provider Details

I. General information

NPI: 1568164168
Provider Name (Legal Business Name): YASEEN OMAR RAMADAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 W BROWARD BLVD
PLANTATION FL
33324-2701
US

IV. Provider business mailing address

7740 NW 50TH ST APT 409
LAUDERHILL FL
33351-5732
US

V. Phone/Fax

Practice location:
  • Phone: 954-829-0639
  • Fax:
Mailing address:
  • Phone: 954-826-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: