Provider Demographics
NPI:1982759726
Name:JAMAL A ABUSUWA MD PA
Entity Type:Organization
Organization Name:JAMAL A ABUSUWA MD PA
Other - Org Name:EXPRESS FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABUSUWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-382-5400
Mailing Address - Street 1:13188 E COLONIAL DR
Mailing Address - Street 2:STE. B 5
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4648
Mailing Address - Country:US
Mailing Address - Phone:407-382-5400
Mailing Address - Fax:407-382-5415
Practice Address - Street 1:13188 E COLONIAL DR
Practice Address - Street 2:STE. B 5
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4648
Practice Address - Country:US
Practice Address - Phone:407-382-5400
Practice Address - Fax:407-382-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87949261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care