Provider Demographics
NPI:1134114416
Name:QURESHI, RIFFAT NISAR (MD)
Entity Type:Individual
Prefix:
First Name:RIFFAT
Middle Name:NISAR
Last Name:QURESHI
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 1:1800 MERCY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-5646
Mailing Address - Country:US
Mailing Address - Phone:407-875-3700
Mailing Address - Fax:407-290-5401
Practice Address - Street 1:1800 MERCY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-5646
Practice Address - Country:US
Practice Address - Phone:407-875-3700
Practice Address - Fax:407-290-5401
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME749172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262672100Medicaid
FL42858YMedicare ID - Type Unspecified
FLG75474Medicare UPIN