Individual
MR. MOHAMMED SIDDIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MT(ASCP)
Contact information
Practice address
4700 MILLENIA BLVD STE 175, ORLANDO, FL 32839-6015
(407) 442-0343
Mailing address
4700 MILLENIA BLVD STE 175, ORLANDO, FL 32839-6015
(407) 442-0343
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
SU4249
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SU4249
STATE OF FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
11/30/2021
Last updated
11/30/2021
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