Provider Demographics
NPI:1316013535
Name:SINADA, MUSADAG MAMOUN (MD)
Entity Type:Individual
Prefix:DR
First Name:MUSADAG
Middle Name:MAMOUN
Last Name:SINADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MUSADAG
Other - Middle Name:MAMOUN MAHGOUB
Other - Last Name:SINADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:830 NW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1212
Mailing Address - Country:US
Mailing Address - Phone:954-702-2100
Mailing Address - Fax:480-878-7431
Practice Address - Street 1:830 NW 82ND AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1212
Practice Address - Country:US
Practice Address - Phone:954-702-2100
Practice Address - Fax:480-878-7431
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086351207R00000X
FLME133245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I 131 55Medicare UPIN