Individual
BIBI HUSSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 BENMORE DR, SUITE 100, WINTER PARK, FL 32792-4111
(407) 644-4883
(407) 644-3697
Mailing address
133 BENMORE DR, SUITE 100, WINTER PARK, FL 32792-4111
(407) 644-4883
(407) 644-3697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107581
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02004675
AMERIGROUP
—
05
—
OO9982900
—
FL
01
—
PA9107581
FLORIDA LICENSE
FL
Enumeration date
10/23/2013
Last updated
12/27/2021
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