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Individual

SHARIQ LATIF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3 BOULDER ROCK DR, PALM COAST, FL 32137-8555
(770) 850-8464
Mailing address
2550 WINDY HILL RD SE, SUITE 206, MARIETTA, GA 30067-8665
(770) 850-8464
(770) 783-8026

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME113190
FL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
ME113190
FL
208VP0000X
Pain Medicine Physician
Primary
ME113190
FL
208VP0014X
Interventional Pain Medicine Physician
ME113190
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010891600
FL
Enumeration date
02/13/2006
Last updated
09/02/2022
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