Provider Demographics
NPI:1033317250
Name:SIDDIQUI, MUNIRA DABIR (MD)
Entity Type:Individual
Prefix:DR
First Name:MUNIRA
Middle Name:DABIR
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 MEASE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-6603
Mailing Address - Country:US
Mailing Address - Phone:727-725-6283
Mailing Address - Fax:813-635-2186
Practice Address - Street 1:1840 MEASE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6602
Practice Address - Country:US
Practice Address - Phone:727-725-6283
Practice Address - Fax:813-635-2186
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108340207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003145000Medicaid
FLP01061452OtherMEDICARE RAILROAD PROVIDER NUMBER
FLP01061452OtherMEDICARE RAILROAD PROVIDER NUMBER
FL003145000Medicaid