Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME101538 | FL |
N | 207QA0505X | Family Doctor - Adult Medicine | 507129 | FL |
NPI | 1053497123 |
---|---|
Provider Name | Dr. Umar Ghaffar |
First Address | Gainesville, FL 32610-0236 |
Second Address | Gainesville, FL 32610-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 24/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001097500 | (05) | FL |