MEDICARE: SARDAR AZIZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME50620	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07933	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1154356327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARDAR AZIZ MD

Provider Business Mailing Address
First Line	:	4564 THORNLEA RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-1241
Country	:	US
Telephone Number	:	407-721-0518
Fax Number	:	407-240-8185

Provider Business Practice Location Address
First Line	:	2500 DISCOVERY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32826-3709
Country	:	US
Telephone Number	:	407-275-2203
Fax Number	:	407-282-7012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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