# M.ATIQ HESSAMI,M.D.,P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033438759
- **Authorized official:** DR. MIRATIQULLAH HESSAMI M.D. (PRESIDENT)
- **Authorized official phone:** (352) 223-5244

## Contact information

- **Practice address:** 33425 E LAKE JOANNA DR, EUSTIS, FL 32736-7249
- **Practice address phone:** (352) 223-5244
- **Mailing address:** 33425 E LAKE JOANNA DR, EUSTIS, FL 32736-7249
- **Mailing address phone:** (352) 223-5244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | P02000071278 | FL | Yes |

## Other

- **Enumeration date:** 05/19/2010
- **Last updated:** 05/19/2010