Provider Demographics
NPI:1346247566
Name:FADHLI, ZAID ATIR (MD)
Entity Type:Individual
Prefix:
First Name:ZAID
Middle Name:ATIR
Last Name:FADHLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2400 N ORANGE BLOSSOM TRL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-2306
Mailing Address - Country:US
Mailing Address - Phone:407-933-2500
Mailing Address - Fax:407-933-0586
Practice Address - Street 1:2400 N ORANGE BLOSSOM TRL
Practice Address - Street 2:SUITE 210
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-2306
Practice Address - Country:US
Practice Address - Phone:407-933-2500
Practice Address - Fax:407-933-0586
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME69278208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378919500Medicaid
FL27832Medicare ID - Type Unspecified
FL378919500Medicaid