Individual
ATIF AHMED SIDDIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3305 US HIGHWAY 98 S, LAKELAND, FL 33803-8365
(863) 777-2740
Mailing address
1205 LAKE CHARLES CIR, LUTZ, FL 33548-4718
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS18123
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2018
Last updated
03/02/2022
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