Provider Demographics
NPI:1790927200
Name:HUDA, FAISAL (MD)
Entity Type:Individual
Prefix:DR
First Name:FAISAL
Middle Name:
Last Name:HUDA
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 1:18501 PINES BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1420
Mailing Address - Country:US
Mailing Address - Phone:954-417-1330
Mailing Address - Fax:954-637-1955
Practice Address - Street 1:18501 PINES BLVD STE 211
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1420
Practice Address - Country:US
Practice Address - Phone:954-417-1330
Practice Address - Fax:954-637-1955
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115739207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program