Provider Demographics
NPI:1629489455
Name:HOSSAIN, MD SAYEM
Entity Type:Individual
Prefix:
First Name:MD
Middle Name:SAYEM
Last Name:HOSSAIN
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 1:11394 SW 36TH RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-0062
Mailing Address - Country:US
Mailing Address - Phone:646-322-3684
Mailing Address - Fax:
Practice Address - Street 1:340 NW COMMERCE DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4709
Practice Address - Country:US
Practice Address - Phone:386-719-9000
Practice Address - Fax:386-719-9013
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME132695207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine