Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 25MA06493600 | NJ |
Y | 207R00000X | Internist | 25MA06493600 | NJ |
Y | 111NI0900X | Internist | 25MA06493600 | NJ |
NPI | 1003801044 |
---|---|
Provider Name | Dr. Fiaz Md Afzal |
First Address | Kissimmee, FL 34741-4121 |
Second Address | Kissimmee, FL 34741-4121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 11/02/2022 |