Provider Demographics
NPI:1801820337
Name:NAEEM, TAHIR (MD)
Entity Type:Individual
Prefix:
First Name:TAHIR
Middle Name:
Last Name:NAEEM
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:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34973-0490
Mailing Address - Country:US
Mailing Address - Phone:863-357-0104
Mailing Address - Fax:863-357-3025
Practice Address - Street 1:2257 US HIGHWAY 441 N STE A
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1943
Practice Address - Country:US
Practice Address - Phone:863-357-0104
Practice Address - Fax:863-357-3025
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71683207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110190573OtherRAILROAD MEDICARE
FL32451OtherBCBS FLORIDA
FL253834200Medicaid
FLME0071683OtherFL MEDICAL LICENSE
FLG40882Medicare UPIN
FL32451ZMedicare PIN