Basic Information
| Provider Information | |||||||||
| NPI: | 1679544704 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALI | ||||||||
| FirstName: | SYED | ||||||||
| MiddleName: | ABBAS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 107 OCEAN CAY WAY | ||||||||
| Address2: | |||||||||
| City: | HYPOLUXO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334625493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548703704 | ||||||||
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| Practice Location | |||||||||
| Address1: | 180 JFK DR STE 134 | ||||||||
| Address2: | |||||||||
| City: | ATLANTIS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616128080 | ||||||||
| FaxNumber: | 5616128084 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2006 | ||||||||
| LastUpdateDate: | 11/14/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | ME93587 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RI0200X | ME93587 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RN0300X | ME93587 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 014507100 | 05 | FL | MEDICAID | 18010 | 01 | FL | BCBS | OTHER |