Provider Demographics
NPI:1386627024
Name:ABOU-SAYED, HATEM AHMED (MD)
Entity Type:Individual
Prefix:
First Name:HATEM
Middle Name:AHMED
Last Name:ABOU-SAYED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 EXECUTIVE DR
Mailing Address - Street 2:STE 105
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3022
Mailing Address - Country:US
Mailing Address - Phone:561-596-2676
Mailing Address - Fax:
Practice Address - Street 1:7231 SW 63RD AVE
Practice Address - Street 2:STE 200
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4810
Practice Address - Country:US
Practice Address - Phone:305-661-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 884452086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA7549112OtherDEA
81254ZMedicare ID - Type Unspecified
BA7549112OtherDEA