Provider Demographics
NPI:1518205780
Name:HUSAIN, BIBI KALISHA (BC-FNP)
Entity Type:Individual
Prefix:MISS
First Name:BIBI
Middle Name:KALISHA
Last Name:HUSAIN
Suffix:
Gender:F
Credentials:BC-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:260 WEKIVA SPRINGS RD
Mailing Address - Street 2:STE 1000
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3699
Mailing Address - Country:US
Mailing Address - Phone:407-423-5178
Mailing Address - Fax:407-423-5616
Practice Address - Street 1:3160 SOUTHGATE COMMERCE BLVD STE 34
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-8550
Practice Address - Country:US
Practice Address - Phone:407-423-5178
Practice Address - Fax:407-423-5616
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2993032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily