Healthcare Provider Details

I. General information

NPI: 1225529894
Provider Name (Legal Business Name): BILAL SADIQ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2018
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 N FLAMINGO RD
PEMBROKE PINES FL
33028
US

IV. Provider business mailing address

3943 STONEFIELD DR
ORLANDO FL
32826-4273
US

V. Phone/Fax

Practice location:
  • Phone: 954-844-4491
  • Fax:
Mailing address:
  • Phone: 312-989-4450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMED-PHYS-COM-LIC-172
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME148015
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number71981
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: