Provider Demographics
NPI:1912398579
Name:KAZMI, MARIUM FATIMA (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIUM
Middle Name:FATIMA
Last Name:KAZMI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4980 W 10TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3437
Mailing Address - Country:US
Mailing Address - Phone:305-557-8444
Mailing Address - Fax:305-557-5058
Practice Address - Street 1:4980 W 10TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3437
Practice Address - Country:US
Practice Address - Phone:305-557-8444
Practice Address - Fax:305-557-5058
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13151207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine