Healthcare Provider Details

I. General information

NPI: 1295798759
Provider Name (Legal Business Name): SAYYED TAHIR HUSSAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10335 CROSS CREEK BLVD STE 20
TAMPA FL
33647-2764
US

IV. Provider business mailing address

10335 CROSS CREEK BLVD STE 20
TAMPA FL
33647-2764
US

V. Phone/Fax

Practice location:
  • Phone: 813-388-6838
  • Fax: 813-388-9526
Mailing address:
  • Phone: 813-388-6838
  • Fax: 813-388-9526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME85377
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME85377
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME85377
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberME85377
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: