Healthcare Provider Details

I. General information

NPI: 1679971030
Provider Name (Legal Business Name): ISMAIL M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7707 N UNIVERSITY DR STE 204
TAMARAC FL
33321-2966
US

IV. Provider business mailing address

7707 N UNIVERSITY DR STE 204
TAMARAC FL
33321-2966
US

V. Phone/Fax

Practice location:
  • Phone: 954-601-6321
  • Fax: 954-231-1227
Mailing address:
  • Phone: 954-601-6321
  • Fax: 954-231-1227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME67059
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD IQBAL ISMAIL
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 954-849-8986