Provider Demographics
NPI:1184904377
Name:HURAIRAH, ABU (MD)
Entity type:Individual
Prefix:
First Name:ABU
Middle Name:
Last Name:HURAIRAH
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 1:2100 OCOEE APOPKA RD STE 110
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-9210
Mailing Address - Country:US
Mailing Address - Phone:407-303-1812
Mailing Address - Fax:407-303-1815
Practice Address - Street 1:2100 OCOEE APOPKA RD STE 110
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703
Practice Address - Country:US
Practice Address - Phone:407-303-1812
Practice Address - Fax:407-303-1815
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME134048207RG0100X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program