Healthcare Provider Details

I. General information

NPI: 1093807950
Provider Name (Legal Business Name): MOHAMMAD ANWARUL HOQUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: M ANWARUL HOQUE M.D.

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HILDA ST STE 15
KISSIMMEE FL
34741
US

IV. Provider business mailing address

PO BOX 421148
KISSIMMEE FL
34742-1148
US

V. Phone/Fax

Practice location:
  • Phone: 407-847-8282
  • Fax: 407-847-3159
Mailing address:
  • Phone: 407-847-8282
  • Fax: 407-847-3159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME0026142
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: