| Imran U Siddiqui Do Pa | |
|
3501 Johnson St Hollywood FL 33021-5421 | |
| (954) 257-7307 | |
| Not Available |
| Full Name | Imran U Siddiqui Do Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3501 Johnson St, Hollywood, Florida |
| Authorized Official Name and Position | Imran Uddin Siddiqui (PRESIDENT) |
| Authorized Official Contact | 9542577307 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imran U Siddiqui Do Pa Po Box 245633 Pembroke Pines FL 33024-0110 Ph: (954) 257-7307 | Imran U Siddiqui Do Pa 3501 Johnson St Hollywood FL 33021-5421 Ph: (954) 257-7307 |
| NPI Number | 1083938054 |
|---|---|
| Provider Enumeration Date | 03/19/2010 |
| Last Update Date | 07/16/2010 |
| Medicare PECOS PAC ID | 6305978073 |
|---|---|
| Medicare Enrollment ID | O20100715000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083938054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS9287 (Florida) | Primary |
| Provider Name | Imram Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720003593 PECOS PAC ID: 1557411089 Enrollment ID: I20090604000133 |
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