MEDICARE: DR. MASOOD MUHAMMAD HUSSAIN

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	363LF0000X	Family Nurse Practitioner	APRN11000277	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F11000277	OTHER	FL	FAMILY NURSE PRACTITIONER

General Provider Information

NPI Number	:	1386115756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MASOOD MUHAMMAD HUSSAIN

Provider Business Mailing Address
First Line	:	14501 SW 157TH PATH
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-6755
Country	:	US
Telephone Number	:	305-926-0444
Fax Number	:

Provider Business Practice Location Address
First Line	:	14501 SW 157TH PATH
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-6755
Country	:	US
Telephone Number	:	305-926-0444
Fax Number	:

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

Provider Enumeration Date	:	12/11/2018
Last Update Date	:	12/28/2018

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