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Organization
MEDICAL CENTER LLC
Active
Organization
MEDICAL CENTER LLC
Active
Other names
The Medical Center of Blountstown
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IQBAL A FAUQUI MD (OWNER PRESIDENT)
(850) 674-2221
Entity
Organization
Contact information
Practice address
20454 NE FINLEY AVE, BLOUNTSTOWN, FL 32424-6012
(850) 674-2221
(850) 674-2121
Mailing address
20454 NE FINLEY AVE, BLOUNTSTOWN, FL 32424-6012
(850) 674-2221
(850) 674-2121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
660205300
—
FL
Enumeration date
12/18/2006
Last updated
02/16/2012
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