Healthcare Provider Details

I. General information

NPI: 1720354921
Provider Name (Legal Business Name): SAJID MUNEER MIRZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 01/26/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 320
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

180 JFK DR STE 320
ATLANTIS FL
33462-6641
US

V. Phone/Fax

Practice location:
  • Phone: 561-548-4900
  • Fax: 561-434-5165
Mailing address:
  • Phone: 561-548-4900
  • Fax: 561-434-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberME141886
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: