Provider Demographics
NPI:1194031369
Name:HUMERAA QAMAR MD, PA
Entity Type:Organization
Organization Name:HUMERAA QAMAR MD, PA
Other - Org Name:CHILDREN'S MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HUMERAA
Authorized Official - Middle Name:
Authorized Official - Last Name:QAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-369-8690
Mailing Address - Street 1:1749 SE 28TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471
Mailing Address - Country:US
Mailing Address - Phone:352-369-8690
Mailing Address - Fax:352-369-8693
Practice Address - Street 1:1749 SE 28TH LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-369-8690
Practice Address - Fax:352-369-8693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73951208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253016300Medicaid
G65436Medicare UPIN