Provider Demographics
NPI:1114238581
Name:MIKAEL, ADEEL H (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEEL
Middle Name:H
Last Name:MIKAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ADEEL
Other - Middle Name:MOHAMMED
Other - Last Name:HUSAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13067 TELECOM PKWY N
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637
Mailing Address - Country:US
Mailing Address - Phone:813-773-6658
Mailing Address - Fax:888-977-1998
Practice Address - Street 1:13067 TELECOM PKWY N
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637
Practice Address - Country:US
Practice Address - Phone:813-773-6658
Practice Address - Fax:888-977-1998
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV-SE-1710207R00000X, 208M00000X
FLME114591208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009395600Medicaid
FLHK716ZMedicare UPIN
FL009395600Medicaid