Healthcare Provider Details

I. General information

NPI: 1285643445
Provider Name (Legal Business Name): MOHAMMAD BADAR ANWER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 CYPRESS PKWY STE 180
KISSIMMEE FL
34759-3329
US

IV. Provider business mailing address

PO BOX 22803
ORLANDO FL
32830-2803
US

V. Phone/Fax

Practice location:
  • Phone: 407-785-6057
  • Fax: 407-530-3345
Mailing address:
  • Phone: 407-870-9992
  • Fax: 407-870-5153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME0071633
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: