Provider Demographics
NPI:1578649646
Name:HUSAIN, TARIK MUHAMMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:TARIK
Middle Name:MUHAMMAD
Last Name:HUSAIN
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 1:3650 NW 82ND AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6662
Mailing Address - Country:US
Mailing Address - Phone:305-537-7272
Mailing Address - Fax:305-537-7274
Practice Address - Street 1:3650 NW 82ND AVE STE 201
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6662
Practice Address - Country:US
Practice Address - Phone:305-537-7272
Practice Address - Fax:305-537-7274
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12441207X00000X
FLME115417207XS0106X, 208200000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery