Provider Demographics
NPI:1174558829
Name:HAMUTH, YUSOOF (MD)
Entity type:Individual
Prefix:
First Name:YUSOOF
Middle Name:
Last Name:HAMUTH
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 1:201 NW 82ND AVE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7808
Mailing Address - Country:US
Mailing Address - Phone:954-473-1300
Mailing Address - Fax:954-473-4595
Practice Address - Street 1:201 NW 82ND AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7808
Practice Address - Country:US
Practice Address - Phone:954-473-1300
Practice Address - Fax:954-473-4595
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0024826207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058477100Medicaid
FL058477100Medicaid
FLE14941Medicare UPIN