Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME142130 | FL |
NPI | 1144662651 |
---|---|
Provider Name | Dr. Safi Haq |
First Address | Clearwater, FL 33759-3012 |
Second Address | Winter Haven, FL 33881-4131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2013 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107815300 | (05) | FL |