Provider Demographics
NPI:1669491726
Name:CHAUDHRY, AZHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:AZHAR
Middle Name:
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 E ALTAMONTE DR 108-410
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4628
Mailing Address - Country:US
Mailing Address - Phone:407-423-4680
Mailing Address - Fax:407-841-7669
Practice Address - Street 1:1811 LUCERNE TER
Practice Address - Street 2:SUITE 3-A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2918
Practice Address - Country:US
Practice Address - Phone:407-423-4680
Practice Address - Fax:407-841-7669
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1669491726OtherNPI
FL268835200Medicaid
FLP00131163OtherMEDICARE RAILROAD
FL03301OtherBLUE CROSS BLUE SHIELD
FL03301OtherBLUE CROSS BLUE SHIELD
FL268835200Medicaid