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General NPI Number Information
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NPI Number | 1669576104
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Entity Type | Individual
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Provider Name | MOHAMMAD RIAZ MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 204 N E 19TH DRIVE
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City | OKEECHOBEE
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State | FL
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Zip | 34972-1932
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Country | US
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Telephone | 863-763-4011
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Fax | 863-467-1156
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Provider Business Mailing Address
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Address Line | PO BOX 1268
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City | OKEECHOBEE
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State | FL
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Zip | 34973-1268
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Country | US
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Telephone | 863-763-4011
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Fax | 863-467-1156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 43238
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License Number State | FL
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