Basic Information
| Provider Information | |||||||||
| NPI: | 1124245782 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALHOMSI | ||||||||
| FirstName: | ABED | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1733 SW 103RD LN | ||||||||
| Address2: | |||||||||
| City: | DAVIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333247465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057768755 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8251 W BROWARD BLVD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333242703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9452557310 | ||||||||
| FaxNumber: | 9542557311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 10/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME104190 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 4301088293 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 001396200 | 05 | FL | MEDICAID | 1468D | 01 | FL | BCBS OF FL | OTHER | P00760450 | 01 | FL | RAILROAD MEDICARE | OTHER |