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Individual

MUBEEN HASAN CHIDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
305 N MANGOUSTINE AVE, STE 200, SANFORD, FL 32771-1004
(407) 321-1415
(407) 321-1597
Mailing address
305 N MANGOUSTINE AVE, STE 200, SANFORD, FL 32771-1004
(407) 321-1415
(407) 321-1597

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0062681
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004826
FLORIDA HEALTHCARE
FL
01
060024107
RAILROAD MEDICARE
FL
01
18042
BCBS OF FLORIDA
FL
01
24527
WELLCARE
FL
05
274254300
FL
Enumeration date
05/23/2005
Last updated
07/09/2007
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