Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | ME0041139 | FL |
NPI | 1083693279 |
---|---|
Provider Name | Dr. Taher Husainy |
First Address | Vero Beach, FL 32960 |
Second Address | Vero Beach, FL 32960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2006 |
Last Update Date | 24/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
069782600 | (05) | FL |
130023529 | RAILROAD MEDICARE (01) | FL |
31144 | BLUE CROSS (01) | FL |
4311627 | AETNA (01) | FL |
592458061001 | CHAMPUS (01) | FL |
D54239 | (02) | FL |
ME0041139 | FLORIDA WORK COMP (01) | FL |