Healthcare Provider Details

I. General information

NPI: 1386627024
Provider Name (Legal Business Name): HATEM AHMED ABOU-SAYED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7231 SW 63RD AVE STE 200
SOUTH MIAMI FL
33143-4810
US

IV. Provider business mailing address

4510 EXECUTIVE DR STE 105
SAN DIEGO CA
92121-3022
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-1996
  • Fax:
Mailing address:
  • Phone: 561-596-2676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME 88445
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: