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General NPI Number Information
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NPI Number | 1760652879
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Entity Type | Individual
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Provider Name | IJLAL UDDIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 4355 BEAR GULLY RD STE 1024
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City | WINTER PARK
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State | FL
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Zip | 32792-9422
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Country | US
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Telephone | 407-288-8750
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Fax | 407-647-0616
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Provider Business Mailing Address
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Address Line | 4355 BEAR GULLY RD STE 1024
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City | WINTER PARK
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State | FL
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Zip | 32792-9422
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Country | US
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Telephone | 407-288-8750
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Fax | 407-647-0616
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD037977
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME107810
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License Number State | FL
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