Provider Demographics
NPI:1104505171
Name:HOSEIN, IAN DEAN
Entity type:Individual
Prefix:PROF
First Name:IAN
Middle Name:DEAN
Last Name:HOSEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30227 SOUTHWELL LN
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5927
Mailing Address - Country:US
Mailing Address - Phone:315-744-8599
Mailing Address - Fax:
Practice Address - Street 1:30227 SOUTHWELL LN
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33543-5927
Practice Address - Country:US
Practice Address - Phone:315-744-8599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach