Provider Demographics
NPI:1255367892
Name:HUSSEIN, AYESHA (MD)
Entity type:Individual
Prefix:
First Name:AYESHA
Middle Name:
Last Name:HUSSEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AYESHA
Other - Middle Name:
Other - Last Name:MONAWAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10968 GOLDEN EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2111
Mailing Address - Country:US
Mailing Address - Phone:727-543-1199
Mailing Address - Fax:
Practice Address - Street 1:10968 GOLDEN EAGLE CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2111
Practice Address - Country:US
Practice Address - Phone:727-543-1199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 82879207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03195OtherBLUE CROSS OF FLORIDA
FL262931300Medicaid
FL262931300Medicaid
930110318Medicare PIN
FLH19642Medicare UPIN