Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME70343 | FL |
N | 2080A0000X | Adolescent Medicine | ME70343 | FL |
NPI | 1275592198 |
---|---|
Provider Name | Iftikher Uddin Mahmood |
First Address | Miami, FL 33169-6036 |
Second Address | Miami, FL 33169-6036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250880000 | (05) | FL |
G96912 | (02) |