Provider Demographics
NPI:1083881668
Name:NAQI, MALIK M (MD)
Entity Type:Individual
Prefix:
First Name:MALIK
Middle Name:M
Last Name:NAQI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 143001
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32614-3001
Mailing Address - Country:US
Mailing Address - Phone:352-379-2742
Mailing Address - Fax:352-379-1485
Practice Address - Street 1:1426 CANYON AVE NE STE C
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-4832
Practice Address - Country:US
Practice Address - Phone:386-208-0537
Practice Address - Fax:386-208-0571
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA234730207R00000X
FLME100575207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000107100Medicaid
FLAK771ZMedicare PIN
FLAK771XMedicare PIN