Provider Demographics
NPI:1801224852
Name:SYED GILANI MD PA
Entity Type:Organization
Organization Name:SYED GILANI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:GILANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-215-5885
Mailing Address - Street 1:PO BOX 15805
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32406-5805
Mailing Address - Country:US
Mailing Address - Phone:850-215-5885
Mailing Address - Fax:850-215-5890
Practice Address - Street 1:237 E BALDWIN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4205
Practice Address - Country:US
Practice Address - Phone:850-215-5885
Practice Address - Fax:850-215-5890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77324174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1114036878OtherNPI-INDIVIDUAL
FLME77324OtherFL STATE LICENSE
FL256734200Medicaid
FLG93352Medicare UPIN