Individual
BASHER M ATIQUZZAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 N ORANGE BLOSSOM TRAIL, SUITE 302, KISSIMMEE, FL 34744-2308
(407) 932-6193
(407) 932-6194
Mailing address
2400 N ORANGE BLOSSOM TRAIL, SUITE 302, KISSIMMEE, FL 34744-2308
(407) 932-6193
(407) 932-6194
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME89652
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279595700
—
FL
01
—
P00392759
RR MEDICARE
FL
Enumeration date
06/08/2006
Last updated
11/06/2013
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