Provider Demographics
NPI:1346558871
Name:ABDUL NADEEM MD LLC
Entity Type:Organization
Organization Name:ABDUL NADEEM MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NADEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-917-1463
Mailing Address - Street 1:7015 GOSLING TER
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-8027
Mailing Address - Country:US
Mailing Address - Phone:941-538-7013
Mailing Address - Fax:
Practice Address - Street 1:1625 S OSPREY AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2929
Practice Address - Country:US
Practice Address - Phone:941-917-1463
Practice Address - Fax:941-917-7543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME795132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME79513OtherSTATE MEDICAL LICENSE