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Organization
MIRZA MEDICAL PA
Active
Organization
MIRZA MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHURRAM MIRZA MD (OWNER)
(954) 335-5500
Entity
Organization
Contact information
Practice address
3075 NW 35TH AVE, LAUDERDALE LAKES, FL 33311-1107
(305) 891-8850
Mailing address
3021 NE 44TH ST, FORT LAUDERDALE, FL 33308-5307
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME122105
FL
Other
Enumeration date
06/12/2017
Last updated
06/12/2017
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