Provider Demographics
NPI:1942560974
Name:HUSSAIN, FAIZUL (DO)
Entity Type:Individual
Prefix:
First Name:FAIZUL
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 SE 9TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1113
Mailing Address - Country:US
Mailing Address - Phone:954-463-0112
Mailing Address - Fax:954-463-0117
Practice Address - Street 1:407 SE 9TH ST STE 103
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1113
Practice Address - Country:US
Practice Address - Phone:954-463-0112
Practice Address - Fax:954-463-0117
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019979207R00000X
FLOS14676207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine