Individual provider Active NPI

Marcel A Hosein

  • Driver
  • Port St Lucie, FL
National Provider Identifier
1497917637
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
4414 SW Abovo St
Port St Lucie, FL 34953-6502
Phone
(772) 342-8711
Fax
(772) 805-8195
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X Primary

Addresses

Primary practice location

4414 SW Abovo St
Port St Lucie, FL 34953-6502

Mailing address

4414 SW Abovo St
Port St Lucie, FL 34953-6502
Phone (772) 342-8711

Other identifiers 2

IdentifierTypeStateIssuer
693720996MedicaidFL
693720998MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1497917637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 SW ABOVO ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349536502",
            "telephone_number": "772-342-8711",
            "fax_number": "772-805-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 SW ABOVO ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349536502",
            "telephone_number": "772-342-8711",
            "fax_number": "772-805-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSEIN",
        "first_name": "MARCEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "693720996",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "693720998",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.