Individual
BILAL ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3890 JENKS AVE, LYNN HAVEN, FL 32444-4701
(850) 215-6400
Mailing address
3890 JENKS AVE, LYNN HAVEN, FL 32444-4701
(850) 630-2554
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME131131
FL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME131131
FL
Other
Enumeration date
04/04/2013
Last updated
08/17/2021
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