Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | ME115174 | FL |
NPI | 1073819975 |
---|---|
Provider Name | Hussnain S Mirza |
First Address | Orlando, FL 32804-4603 |
Second Address | Orlando, FL 32803-1248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2011 |
Last Update Date | 07/08/2013 |