MEDICARE: DR. TAHER HUSAINY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	ME41139	FL
2	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	ME0041139	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	130023529	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	31144	OTHER	FL	BLUE CROSS
3	592458061001	OTHER	FL	CHAMPUS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4311627	OTHER	FL	AETNA
6	ME41139	OTHER	FL	MEDICAL LICENSE
7	ME0041139	OTHER	FL	FLORIDA WORK COMP
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083693279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAHER HUSAINY MD

Provider Business Mailing Address
First Line	:	9960 NW 116TH WAY STE 13
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33178-1175
Country	:	US
Telephone Number	:	786-924-1311
Fax Number	:	786-924-1313

Provider Business Practice Location Address
First Line	:	1395 N COURTENAY PKWY STE 106
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-4474
Country	:	US
Telephone Number	:	321-452-1224
Fax Number	:	321-453-7784

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	05/08/2026

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Directions to “ DR. TAHER HUSAINY MD” Practice Location

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