Organization
MOHAMMAD ALI FAISAL MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD FAISAL MD (PRESIDENT)
(386) 758-5985
Entity
Organization
Contact information
Practice address
1283 SW STATE RD 47, STE 104, LAKE CITY, FL 32025
(386) 758-5985
Mailing address
PO BOX 3009, LAKE CITY, FL 32056
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051283400
—
FL
Enumeration date
05/14/2014
Last updated
05/14/2014
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