Individual
MOHAMMAD RIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
204 N E 19TH DRIVE, OKEECHOBEE, FL 34972-1932
(863) 763-4011
(863) 467-1156
Mailing address
PO BOX 1268, OKEECHOBEE, FL 34973-1268
(863) 763-4011
(863) 467-1156
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
43238
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060054371
RAILROAD MEDICARE
FL
05
—
068559300
—
FL
01
—
10D2014769
CLIA CERTIFICATE OF WAIVER
FL
01
—
592401624
TRICARE
FL
Enumeration date
09/12/2006
Last updated
06/02/2015
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