Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 5101015831 | MI |
N | 111NI0900X | Internist | 5101015831 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 7294934-1204 | UT |
N | 207RC0000X | Internist - Cardiovascular Disease | OS 10711 | FL |
Y | 207RI0011X | Interventional Cardiology | OS10711 | FL |
NPI | 1063548097 |
---|---|
Provider Name | Dr. Irfan F Siddiqui |
First Address | Orlando, FL 32885-0188 |
Second Address | Davenport, FL 33837-7811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 13/02/2018 |