Provider Demographics
NPI:1508026527
Name:ABBAS, HUSAIN M (MD)
Entity Type:Individual
Prefix:
First Name:HUSAIN
Middle Name:M
Last Name:ABBAS
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3627 UNIVERSITY BLVD S
Mailing Address - Street 2:SUITE 700
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4230
Mailing Address - Country:US
Mailing Address - Phone:904-399-5678
Mailing Address - Fax:904-399-8488
Practice Address - Street 1:3627 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 700
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4230
Practice Address - Country:US
Practice Address - Phone:904-399-5678
Practice Address - Fax:904-399-8488
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2022-02-09
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME113201208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007624500Medicaid
FLGV009ZMedicare PIN