Ibrahim, Hisham Izzadin

Ibrahim, Hisham Izzadin is an individual health care provider with primary practice located at 1210 E Plant St Ste 120 , Winter Garden FL 34787-2995. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Ibrahim, Hisham Izzadin can be contacted via phone (407) 297-8408.

Contact Information

Primary practice address
1210 E Plant St Ste 120 Winter Garden FL 34787-2995
Phone: (407) 297-8408
Fax: (407) 297-8408
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 17166 Nevada

Profile Details

NPI number 1619918760
LBN Legal business name Ibrahim, Hisham Izzadin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Mar 25th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619918760 NPPES
Florida Other ME114722 LICENSE
Florida MEDICAID 1619918760 LICENSE

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