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General NPI Number Information
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NPI Number | 1235306820
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Entity Type | Organization
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Legal Business Name | T S HOSSAIN MD PA
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 301 HEALTH PARK BLVD SUITE #215
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City | ST AUGUSTINE
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State | FL
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Zip | 32086
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Country | US
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Telephone | 904-823-3394
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Fax | 904-823-8557
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Provider Business Mailing Address
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Address Line | 301 HEALTH PARK BLVD SUITE #215
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City | ST AUGUSTINE
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State | FL
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Zip | 32086
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Country | US
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Telephone | 904-823-3394
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Fax | 904-823-8557
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAWHID SIMON HOSSAIN
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Credential | MD
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Telephone | 904-823-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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