Provider Demographics
NPI:1164460788
Name:QURESHI, AMBREEN (MD)
Entity Type:Individual
Prefix:
First Name:AMBREEN
Middle Name:
Last Name:QURESHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 HENDERSON BLVD STE 701
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-4940
Mailing Address - Country:US
Mailing Address - Phone:813-474-3636
Mailing Address - Fax:813-862-2536
Practice Address - Street 1:2106 ASHLEY OAKS CIR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6417
Practice Address - Country:US
Practice Address - Phone:813-474-3636
Practice Address - Fax:813-862-2536
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME115520207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009695700Medicaid
FLP01210216OtherR&R MEDICARE
FLHL062ZMedicare PIN