Healthcare Provider Details

I. General information

NPI: 1386057966
Provider Name (Legal Business Name): HUSSEIN ANAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 NE 26TH ST STE 238
WILTON MANORS FL
33305-1426
US

IV. Provider business mailing address

1881 NE 26TH ST STE 238
WILTON MANORS FL
33305-1426
US

V. Phone/Fax

Practice location:
  • Phone: 954-686-4263
  • Fax: 833-973-5793
Mailing address:
  • Phone: 347-634-6469
  • Fax: 954-405-8836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME143786
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME143786
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: