Provider Demographics
NPI:1679544704
Name:ALI, SYED ABBAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:ABBAS
Last Name:ALI
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 1:107 OCEAN CAY WAY
Mailing Address - Street 2:
Mailing Address - City:HYPOLUXO
Mailing Address - State:FL
Mailing Address - Zip Code:33462-5493
Mailing Address - Country:US
Mailing Address - Phone:954-870-3704
Mailing Address - Fax:
Practice Address - Street 1:180 JFK DR STE 134
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:561-612-8080
Practice Address - Fax:561-612-8084
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93587207RC0200X, 207RI0200X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014507100Medicaid
FL18010OtherBCBS