Healthcare Provider Details

I. General information

NPI: 1851300941
Provider Name (Legal Business Name): MIRZA ABID BAIG M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2006
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 N UNIVERSITY DR PATHOLOGY DEPT
TAMARAC FL
33321-2913
US

IV. Provider business mailing address

7111 FAIRWAY DR SUITE 400
PALM BEACH GARDENS FL
33418-4204
US

V. Phone/Fax

Practice location:
  • Phone: 407-454-1540
  • Fax:
Mailing address:
  • Phone: 800-330-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberME92727
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME 92727
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: