Provider Demographics
NPI:1285131169
Name:ABOULENAIN, SAMAR IBRAHIM MOHAMED HUSS (MD)
Entity type:Individual
Prefix:
First Name:SAMAR
Middle Name:IBRAHIM MOHAMED HUSS
Last Name:ABOULENAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 QUEEN PARK CRESCENT W.
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M5G3H2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:180 JFK DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:561-548-1450
Practice Address - Fax:561-548-1459
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program