Provider Demographics
NPI:1649444944
Name:HMADEH, MOHAMMAD YASSIN MRIDA (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD YASSIN
Middle Name:MRIDA
Last Name:HMADEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMAD
Other - Middle Name:YASSIN
Other - Last Name:HMADEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2501 N ORANGE AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4644
Mailing Address - Country:US
Mailing Address - Phone:407-303-7283
Mailing Address - Fax:407-303-0347
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:CRITICAL CARE SPECIALISTS
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-7283
Practice Address - Fax:407-303-0347
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081463207RC0200X, 207RP1001X
RIMD12892207RC0200X, 207RP1001X
FLME120922207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease