Provider Demographics
NPI:1750661419
Name:BAIG, IFTEKHAR (DO)
Entity Type:Individual
Prefix:
First Name:IFTEKHAR
Middle Name:
Last Name:BAIG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 INDIAN ROCKS RD S
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-1035
Mailing Address - Country:US
Mailing Address - Phone:727-586-7103
Mailing Address - Fax:727-585-7205
Practice Address - Street 1:2010 59TH ST W STE 4200
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-4687
Practice Address - Country:US
Practice Address - Phone:941-794-3999
Practice Address - Fax:941-792-4048
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO2895207R00000X
FLOS12229208D00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty