Provider Demographics
NPI:1437236239
Name:YUSOOF HAMUTH MDPA
Entity Type:Organization
Organization Name:YUSOOF HAMUTH MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YUSOOF
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-473-1300
Mailing Address - Street 1:201 NW 82ND AVE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7808
Mailing Address - Country:US
Mailing Address - Phone:954-473-1300
Mailing Address - Fax:954-473-4595
Practice Address - Street 1:201 NW 82ND AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7808
Practice Address - Country:US
Practice Address - Phone:954-473-1300
Practice Address - Fax:954-473-4595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0024826261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL93242Medicare PIN
FLE14941Medicare UPIN