Provider Demographics
NPI:1760479430
Name:SULTAN, HASHEM (MD)
Entity Type:Individual
Prefix:DR
First Name:HASHEM
Middle Name:
Last Name:SULTAN
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:PO BOX 824610
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33082-4610
Mailing Address - Country:US
Mailing Address - Phone:305-559-5554
Mailing Address - Fax:305-559-5515
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:411
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-559-5554
Practice Address - Fax:305-559-5515
Is Sole Proprietor?:No
Enumeration Date:2005-09-28
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75237174400000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254240400Medicaid
FM43324AMedicare ID - Type Unspecified
FL254240400Medicaid