Provider Demographics
NPI:1154567642
Name:AZMAT, HINA (MD)
Entity type:Individual
Prefix:
First Name:HINA
Middle Name:
Last Name:AZMAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:770 DELTONA BOULEVARD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725
Mailing Address - Country:US
Mailing Address - Phone:386-259-9902
Mailing Address - Fax:407-218-8901
Practice Address - Street 1:770 DELTONA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-7168
Practice Address - Country:US
Practice Address - Phone:386-259-9902
Practice Address - Fax:407-218-8901
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME91660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI51990Medicare UPIN