Provider Demographics
NPI:1134111990
Name:QAZI, ARIF M (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIF
Middle Name:M
Last Name:QAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 MEDICAL CARE DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5942
Mailing Address - Country:US
Mailing Address - Phone:813-685-5100
Mailing Address - Fax:813-689-6797
Practice Address - Street 1:609 MEDICAL CARE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5942
Practice Address - Country:US
Practice Address - Phone:813-685-5100
Practice Address - Fax:813-689-6797
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083486Q207R00000X
FLME104916207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000979000Medicaid
OH2455687Medicaid
FL000979000Medicaid
FLBZ810ZMedicare PIN
OH2455687Medicaid