Provider Demographics
NPI:1295762904
Name:AMIN, BINITA (MD)
Entity type:Individual
Prefix:DR
First Name:BINITA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3228 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-7423
Mailing Address - Country:US
Mailing Address - Phone:850-784-2611
Mailing Address - Fax:850-784-2614
Practice Address - Street 1:3228 E 15TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-7423
Practice Address - Country:US
Practice Address - Phone:850-784-2611
Practice Address - Fax:850-784-2614
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90802174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2746573 00Medicaid
FLI50940Medicare UPIN
FL2746573 00Medicaid