Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | A152878 | CA |
Y | 2080P0210X | Pediatric Nephrologist | ME146261 | FL |
NPI | 1174904734 |
---|---|
Provider Name | Aslam Hyder Qureshi |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33908-3838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2015 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107170800 | (05) | FL |