Provider Demographics
NPI:1346612561
Name:QADRI, SUBUHI (DMD)
Entity Type:Individual
Prefix:
First Name:SUBUHI
Middle Name:
Last Name:QADRI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 E ALTAMONTE DR
Mailing Address - Street 2:SUITE 1279
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4613
Mailing Address - Country:US
Mailing Address - Phone:407-580-3795
Mailing Address - Fax:
Practice Address - Street 1:451 E ALTAMONTE DR
Practice Address - Street 2:SUITE 1279
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4613
Practice Address - Country:US
Practice Address - Phone:407-580-3795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL215571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice