Provider Demographics
NPI:1740559715
Name:MOHAMMAD YUNUS MD PA
Entity Type:Organization
Organization Name:MOHAMMAD YUNUS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-547-4284
Mailing Address - Street 1:404 E HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-2731
Mailing Address - Country:US
Mailing Address - Phone:850-547-4284
Mailing Address - Fax:850-547-5415
Practice Address - Street 1:404 E HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425-2731
Practice Address - Country:US
Practice Address - Phone:850-547-4284
Practice Address - Fax:850-547-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty