Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | ME 87941 | FL |
NPI | 1194701094 |
---|---|
Provider Name | Dr. Musarrat N Qureshi |
First Address | Lakeland, FL 33813 |
Second Address | Lakeland, FL 33813 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 17/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
267392400 | (05) | FL |
5593926 | FIRST HEALTH (01) | FL |
71563 | BLUECROSSBLUESHIELD (01) | FL |
H96200 | (02) | FL |