Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME0085486 | FL |
NPI | 1235187527 |
---|---|
Provider Name | Dr. Syed Naseeruddin |
First Address | Saint Cloud, FL 34769-6519 |
Second Address | Saint Cloud, FL 34769-6519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 30/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
264759100 | (05) | FL |
H42239 | (02) | FL |