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NPI Code Detail

MEDICARE: DR. MUHAMMAD M SIDDIQUI M.D.

MEDICARE: DR. MUHAMMAD M SIDDIQUI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistME23240FL
2207R00000XInternal Medicine PhysicianME00232410FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME23240OTHERFLFLORIDA STATE LICENSE

General Provider Information

NPI Number : 1407853005
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MUHAMMAD M SIDDIQUI M.D.
Provider Business Mailing Address
First Line : 1555 INDIAN RIVER BLVD STE B210
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-7113
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-252-3245
Provider Business Practice Location Address
First Line : 13505 US HIGHWAY 1
Second Line :
City : SEBASTIAN
State : FL
Zip : 32958-3759
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 02/07/2025

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