Provider Demographics
NPI:1003377912
Name:HUSAIN, SYED MUBASHIR (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:MUBASHIR
Last Name:HUSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-473-7642
Mailing Address - Fax:954-473-7686
Practice Address - Street 1:3896 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6612
Practice Address - Country:US
Practice Address - Phone:954-933-9600
Practice Address - Fax:954-781-9828
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT8299208M00000X, 208M00000X
FLME162499207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine