MEDICARE: MUSHTAQ HUSSAIN M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME0060313	FL

General Provider Information

NPI Number	:	1427155761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUSHTAQ HUSSAIN M.D.

Provider Business Mailing Address
First Line	:	5901 SW 74TH ST
Second Line	:	SUITE 202
City	:	MIAMI
State	:	FL
Zip	:	33143-5165
Country	:	US
Telephone Number	:	305-665-4614
Fax Number	:	305-667-0239

Provider Business Practice Location Address
First Line	:	1796 HWY 441 NORTH
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972
Country	:	US
Telephone Number	:	305-665-4614
Fax Number	:	305-667-0239

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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