Healthcare Provider Details

I. General information

NPI: 1134705684
Provider Name (Legal Business Name): UMAR IQBAL M.B.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SHANDS HOSPITAL 1600 SW ARCHER ROAD
GAINESVILLE FL
32610-0001
US

IV. Provider business mailing address

225 ELMWOOD AVE APT 2B
BUFFALO NY
14222-2301
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0239
  • Fax: 352-265-1107
Mailing address:
  • Phone: 716-322-8905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: