Provider Demographics
NPI:1588723373
Name:DABIEN, NASSER (PA)
Entity type:Individual
Prefix:
First Name:NASSER
Middle Name:
Last Name:DABIEN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8814 NW 180TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6503
Mailing Address - Country:US
Mailing Address - Phone:786-390-4789
Mailing Address - Fax:
Practice Address - Street 1:8814 NW 180TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-6503
Practice Address - Country:US
Practice Address - Phone:786-390-4789
Practice Address - Fax:305-819-8198
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101660363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL291175200Medicaid
FL291175200Medicaid
FLE6693XMedicare ID - Type UnspecifiedMEDICARE PROVIDER