Individual
DR. ASHFAQ LATIF KUDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 PLANTATION ISLAND DR S STE 302A, ST AUGUSTINE, FL 32080-3117
(904) 461-9330
(904) 461-9331
Mailing address
1301 PLANTATION ISLAND DR S STE 302A, ST AUGUSTINE, FL 32080-3117
(904) 461-9330
(904) 461-9331
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0068850
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28138
BCBS
FL
05
—
379026600
—
FL
Enumeration date
08/08/2006
Last updated
12/11/2024
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