Provider Demographics
NPI:1619172814
Name:MD NASIRUL HUQ MD PA
Entity Type:Organization
Organization Name:MD NASIRUL HUQ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASIRUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-237-0130
Mailing Address - Street 1:3233 SW 33RD RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-8470
Mailing Address - Country:US
Mailing Address - Phone:352-237-0130
Mailing Address - Fax:352-237-0129
Practice Address - Street 1:3233 SW 33RD RD
Practice Address - Street 2:SUITE 302
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-8470
Practice Address - Country:US
Practice Address - Phone:352-237-0130
Practice Address - Fax:352-237-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261159700Medicaid
FL261159700Medicaid