Individual
MR. ASIF MIRZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 W LAKE MARY BLVD, SUITE 101, LAKE MARY, FL 32746-3501
(407) 936-0976
(407) 936-0977
Mailing address
1629 ROCKDALE LOOP, LAKE MARY, FL 32746-5332
(407) 333-1928
(407) 936-0977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME78737
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260955000
—
FL
Enumeration date
05/04/2006
Last updated
07/20/2010
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