Provider Demographics
NPI:1124245782
Name:ALHOMSI, ABED (MD)
Entity type:Individual
Prefix:
First Name:ABED
Middle Name:
Last Name:ALHOMSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 SW 103RD LN
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7465
Mailing Address - Country:US
Mailing Address - Phone:305-776-8755
Mailing Address - Fax:
Practice Address - Street 1:8251 W BROWARD BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2703
Practice Address - Country:US
Practice Address - Phone:945-255-7310
Practice Address - Fax:954-255-7311
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104190207R00000X
MI4301088293207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001396200Medicaid
FL1468DOtherBCBS OF FL
FLP00760450OtherRAILROAD MEDICARE
FLP00760450OtherRAILROAD MEDICARE