Provider Demographics
NPI:1215367347
Name:RAFIQ, ANEEQ S (MD)
Entity Type:Individual
Prefix:
First Name:ANEEQ
Middle Name:S
Last Name:RAFIQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANEEQ
Other - Middle Name:S
Other - Last Name:RAFIQ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4020 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9416
Mailing Address - Country:US
Mailing Address - Phone:855-226-6633
Mailing Address - Fax:954-983-1152
Practice Address - Street 1:4020 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9416
Practice Address - Country:US
Practice Address - Phone:855-226-6633
Practice Address - Fax:954-983-1152
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN856208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019350600Medicaid