Healthcare Provider Details

I. General information

NPI: 1265782817
Provider Name (Legal Business Name): FATIMA HAKIMUDDIN NEEMUCHWALA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5153 NORTH 9TH AVE 6TH FLOOR NEMOURS
PENSACOLA FL
32504
US

IV. Provider business mailing address

5153 NORTH 9TH AVE 6TH FLOOR NEMOURS
PENSACOLA FL
32504
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-7658
  • Fax: 850-416-7677
Mailing address:
  • Phone: 850-416-7658
  • Fax: 850-416-7677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTRN17694
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301106853
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number4301106853
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: