MEDICARE: ISHRAT UNNISA KAZMI M.D.

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	208000000X	Pediatrics Physician	ME93909	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982624789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISHRAT UNNISA KAZMI M.D.

Provider Business Mailing Address
First Line	:	131 N OAKWOOD AVE
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33510-4629
Country	:	US
Telephone Number	:	813-655-5106
Fax Number	:	813-655-4460

Provider Business Practice Location Address
First Line	:	131 N OAKWOOD AVE
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33510-4629
Country	:	US
Telephone Number	:	813-655-5106
Fax Number	:	813-655-4460

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	01/27/2023

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