Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | ME134543 | FL |
Y | 207RX0202X | Medical Oncology | ME134543 | FL |
NPI | 1366588816 |
---|---|
Provider Name | Dr. Mohsin I Malik |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Tavares, FL 32778 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 16/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101347600 | (05) | FL |
3RNMF | BCBS FL (01) | FL |