Provider Demographics
NPI:1972505410
Name:HOSEIN, FIRAZ RICHARD (DO)
Entity Type:Individual
Prefix:DR
First Name:FIRAZ
Middle Name:RICHARD
Last Name:HOSEIN
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 1:1 W SAMPLE RD
Mailing Address - Street 2:201
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3547
Mailing Address - Country:US
Mailing Address - Phone:954-782-3170
Mailing Address - Fax:954-782-3171
Practice Address - Street 1:1 W SAMPLE RD
Practice Address - Street 2:201
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3547
Practice Address - Country:US
Practice Address - Phone:954-782-3170
Practice Address - Fax:954-782-3171
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8550207R00000X, 207RH0002X
GA056084207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012440000Medicaid
FLH78664Medicare UPIN
FL012440000Medicaid