MEDICARE: DR. HASSAN ZULFIQAR MD

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	207RG0100X	Gastroenterology Physician	ME78417	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	46913	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1487684171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HASSAN ZULFIQAR MD

Provider Business Mailing Address
First Line	:	1690 DUNLAWTON AVE
Second Line	:	SUITE # 210
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-8980
Country	:	US
Telephone Number	:	386-763-4920
Fax Number	:	386-763-4939

Provider Business Practice Location Address
First Line	:	870 DUNLAWTON AVE STE 210A
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-9274
Country	:	US
Telephone Number	:	386-518-3671
Fax Number	:	386-233-7510

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	08/09/2024

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