Individual
M. SIRAJ UL ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
710 OAK COMMONS BLVD, KISSIMMEE, FL 34741-4100
(407) 518-1199
(407) 569-1201
Mailing address
PO BOX 423009, KISSIMMEE, FL 34742-3009
(407) 518-1199
(407) 569-1201
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0048529
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045481800
—
FL
Enumeration date
06/15/2006
Last updated
07/19/2012
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