Provider Demographics
NPI:1154183317
Name:SHOUBAKI, HUSSIEN
Entity type:Individual
Prefix:
First Name:HUSSIEN
Middle Name:
Last Name:SHOUBAKI
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 1:3021 W VAN BUREN DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-5329
Mailing Address - Country:US
Mailing Address - Phone:656-218-1900
Mailing Address - Fax:
Practice Address - Street 1:205 S HOOVER BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3500
Practice Address - Country:US
Practice Address - Phone:656-218-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)