Healthcare Provider Details

I. General information

NPI: 1588827646
Provider Name (Legal Business Name): INTESAR HUSSAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 03/01/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD
TAMPA FL
33612-4745
US

IV. Provider business mailing address

1138 BERING RD
WESLEY CHAPEL FL
33543-7078
US

V. Phone/Fax

Practice location:
  • Phone: 773-822-3968
  • Fax:
Mailing address:
  • Phone: 773-822-3968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME133007
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036.130904
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: