Basic Information
Provider Information
NPI: 1588920193
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUHAMMAD
FirstName: FURQAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 86 W UNDERWOOD ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328061110
CountryCode: US
TelephoneNumber: 8889123648
FaxNumber: 3218414085
Practice Location
Address1: 86 W UNDERWOOD ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328061110
CountryCode: US
TelephoneNumber: 8889123648
FaxNumber: 3218414085
Other Information
ProviderEnumerationDate: 04/09/2012
LastUpdateDate: 03/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RA0000X31104OKN Allopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
208M00000X31104OKN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000XME122760FLY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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