| Doctor Name: | ABDUL SAMAD MEMON |
| NPI Number: | 1104128305 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 9105666 |
| Business Practice Address: | 450 W Sr 434 Ste 3010 Longwood, FL - 327505196 |
| Business Phone Number: | 4077678200 |
| Business Fax Number: | |
| Mailing Address: | 9140 Sw 153rd Ave, MIAMI |
| State: | FL |
| Postal Code: | 331962853 |
| Phone Number: | 3052134838 |
| Fax Number: | |
| NPI Enumeration Date: | 11/22/2010 |
| NPI Last Update Date: | 11/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 9105666 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |