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NPI Code Detail

MEDICARE: AZHAR A MALIK M.D

MEDICARE: AZHAR A MALIK 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
1174400000XSpecialistME82487FL
2207RN0300XNephrology PhysicianME82487FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609872670
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZHAR A MALIK M.D
Provider Business Mailing Address
First Line : 511 MEDICAL OAKS AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-5961
Country : US
Telephone Number : 813-681-8212
Fax Number : 813-654-0478
Provider Business Practice Location Address
First Line : 12662 TELECOM DR
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33637-0935
Country : US
Telephone Number : 813-910-0030
Fax Number : 813-971-6473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 07/25/2019

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