MEDICARE: FAMILY MEDICINE & REHAB

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1427481647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICINE & REHAB

Provider Business Mailing Address
First Line	:	7685 103RD ST
Second Line	:	SUITE 4
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-9325
Country	:	US
Telephone Number	:	904-388-7964
Fax Number	:	904-388-7002

Provider Business Practice Location Address
First Line	:	7685 103RD ST
Second Line	:	SUITE 4
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-9325
Country	:	US
Telephone Number	:	904-388-7964
Fax Number	:	904-388-7002

Authorized Official
Title or Position	:	PESIDENT
Name	:	SYED SAJID HUSSAIN
Credential	:	MD
Telephone Number	:	904-388-7964

Provider Enumeration Date	:	08/12/2013
Last Update Date	:	08/12/2013

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Directions to “FAMILY MEDICINE & REHAB ” Practice Location

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