Healthcare Provider Details

I. General information

NPI: 1902865652
Provider Name (Legal Business Name): HUMERAA QAMAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1749 SE 28TH LOOP
OCALA FL
34471-1079
US

IV. Provider business mailing address

1749 SE 28TH LOOP
OCALA FL
34471-1079
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-8690
  • Fax: 352-369-8693
Mailing address:
  • Phone: 352-369-8690
  • Fax: 352-369-8693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0073951
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: