Healthcare Provider Details

I. General information

NPI: 1669492997
Provider Name (Legal Business Name): FARID HUSSAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1553 US HIGHWAY 1
VERO BEACH FL
32960-5735
US

IV. Provider business mailing address

1555 INDIAN RIVER BLVD STE B210
VERO BEACH FL
32960-7113
US

V. Phone/Fax

Practice location:
  • Phone: 772-257-8224
  • Fax: 772-252-3245
Mailing address:
  • Phone: 772-257-8224
  • Fax: 772-252-3245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME119096
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: