Provider Demographics
NPI:1477525319
Name:DOCTOR FOR ADULTS, INC
Entity Type:Organization
Organization Name:DOCTOR FOR ADULTS, INC
Other - Org Name:TAHSINA Y. ATIQUZZAMAN, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAHSINA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ATIQUZZAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-846-6331
Mailing Address - Street 1:505 W OAK ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4986
Mailing Address - Country:US
Mailing Address - Phone:407-846-6331
Mailing Address - Fax:407-846-0137
Practice Address - Street 1:505 W OAK ST
Practice Address - Street 2:SUITE 202
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4986
Practice Address - Country:US
Practice Address - Phone:407-846-6331
Practice Address - Fax:407-846-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-05
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274425200Medicaid
FLK9823Medicare PIN