MEDICARE: MR. MUHAMMAD AMIN 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
1	208600000X	Surgery Physician	ME33481	FL
2	208D00000X	General Practice Physician	ME#0033481	FL
3	208600000X	Surgery Physician	ME#0033481	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	03573	OTHER	FL	BLUE CROSS

General Provider Information

NPI Number	:	1457353310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MUHAMMAD AMIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 367
Second Line	:
City	:	BONIFAY
State	:	FL
Zip	:	32425
Country	:	US
Telephone Number	:	850-547-3679
Fax Number	:	850-547-3524

Provider Business Practice Location Address
First Line	:	402 EAST BYRD AVE
Second Line	:
City	:	BONIFAY
State	:	FL
Zip	:	32425
Country	:	US
Telephone Number	:	850-547-3679
Fax Number	:	850-547-3524

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/02/2010

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