Provider Demographics
NPI:1356651848
Name:ANEES, MUHAMMAD (PA)
Entity Type:Individual
Prefix:MR
First Name:MUHAMMAD
Middle Name:
Last Name:ANEES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 JERNIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-4220
Mailing Address - Country:US
Mailing Address - Phone:850-547-0988
Mailing Address - Fax:850-547-3205
Practice Address - Street 1:110 JERNIGAN AVE
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425-4220
Practice Address - Country:US
Practice Address - Phone:850-547-0988
Practice Address - Fax:850-547-3205
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100246363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290667800Medicaid