Healthcare Provider Details

I. General information

NPI: 1942722343
Provider Name (Legal Business Name): MADIHA SAJID NOOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

17325 PAGONIA RD
CLERMONT FL
34711-6008
US

V. Phone/Fax

Practice location:
  • Phone: 407-975-0412
  • Fax: 407-975-0413
Mailing address:
  • Phone: 407-905-6014
  • Fax: 407-654-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME145178
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN25565
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: