MEDICARE: MUBEEN HASAN CHIDA 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	174400000X	Specialist	ME0062681	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	060024107	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	004826	OTHER	FL	FLORIDA HEALTHCARE
3	18042	OTHER	FL	BCBS OF FLORIDA
4	24527	OTHER	FL	WELLCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992708168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUBEEN HASAN CHIDA M.D.

Provider Business Mailing Address
First Line	:	305 N MANGOUSTINE AVE
Second Line	:	STE 200
City	:	SANFORD
State	:	FL
Zip	:	32771-1004
Country	:	US
Telephone Number	:	407-321-1415
Fax Number	:	407-321-1597

Provider Business Practice Location Address
First Line	:	305 N MANGOUSTINE AVE
Second Line	:	STE 200
City	:	SANFORD
State	:	FL
Zip	:	32771-1004
Country	:	US
Telephone Number	:	407-321-1415
Fax Number	:	407-321-1597

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/09/2007

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Directions to “ MUBEEN HASAN CHIDA M.D.” Practice Location

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