Provider Demographics
NPI:1407470099
Name:ABDULAMEER, HUSSEIN A
Entity Type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:A
Last Name:ABDULAMEER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5081 MINA CIR
Mailing Address - Street 2:APT 411
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-6589
Mailing Address - Country:US
Mailing Address - Phone:603-264-5853
Mailing Address - Fax:
Practice Address - Street 1:28540 TRANQUIL LAKE CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-6589
Practice Address - Country:US
Practice Address - Phone:603-264-5853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-30
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24908122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist