Healthcare Provider Details

I. General information

NPI: 1588920193
Provider Name (Legal Business Name): FURQAN MUHAMMAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 GRAY AVE
WILDWOOD FL
34785-3520
US

IV. Provider business mailing address

601 GRAY AVE
WILDWOOD FL
34785-3520
US

V. Phone/Fax

Practice location:
  • Phone: 352-399-2422
  • Fax: 352-399-2427
Mailing address:
  • Phone: 352-399-2422
  • Fax: 352-399-2427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number31104
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number31104
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberME122760
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME122760
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: