Provider Demographics
NPI:1548598055
Name:ISLAM, ZUNAIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZUNAIRA
Middle Name:
Last Name:ISLAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 W STATE ROAD 434
Mailing Address - Street 2:SUITE #2110
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-5041
Mailing Address - Country:US
Mailing Address - Phone:407-647-2346
Mailing Address - Fax:407-647-5431
Practice Address - Street 1:2180 W STATE ROAD 434
Practice Address - Street 2:SUITE #2110
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-5041
Practice Address - Country:US
Practice Address - Phone:407-647-2346
Practice Address - Fax:407-647-5431
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC148846207R00000X
FLME111893207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine