Provider Demographics
NPI:1336176700
Name:HYDER, MANSOOR (MD)
Entity Type:Individual
Prefix:DR
First Name:MANSOOR
Middle Name:
Last Name:HYDER
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 1:13300 WALSINGHAM RD
Mailing Address - Street 2:APT # 91
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3541
Mailing Address - Country:US
Mailing Address - Phone:727-593-5638
Mailing Address - Fax:
Practice Address - Street 1:10000 BAYPINE BLVD
Practice Address - Street 2:
Practice Address - City:BAY PINE
Practice Address - State:FL
Practice Address - Zip Code:33744
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33169207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine