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Individual

BASIMA MUHAMMED ABDUL-RAZAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
601 E ROLLINS ST, ORLANDO, FL 32803
(407) 975-0412
(407) 975-0413
Mailing address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 975-0412
(407) 975-0413

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301068389
MI
208000000X
Pediatrics Physician
Primary
C53991
CA
208000000X
Pediatrics Physician
ME134057
FL
208000000X
Pediatrics Physician
U5052
TX
208M00000X
Hospitalist Physician
ME134057
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000005503A
CAPE PIN NUMBER
01
023862
MIDWEST PIN #
01
0634484
BCBS/BCN PIN NUMBER
01
146412
GREAT LAKES HEALTH PLAN#
01
16502
HEALTH PLAN OF MICHIGAN#
01
16528
MCARE PIN #
05
4331048-10
MI
05
4673447-10
MI
01
7686102
AETNA PROVIDER NUMBER
Enumeration date
07/01/2006
Last updated
03/22/2025
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