Provider Demographics
NPI:1457396301
Name:NAGID, ENRIQUE G (MD)
Entity Type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:G
Last Name:NAGID
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 1:190 JOHN F KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1186
Mailing Address - Country:US
Mailing Address - Phone:561-964-3003
Mailing Address - Fax:561-642-8868
Practice Address - Street 1:190 JOHN F KENNEDY DR
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1186
Practice Address - Country:US
Practice Address - Phone:561-964-3003
Practice Address - Fax:561-642-8868
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME23787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50665YMedicare ID - Type UnspecifiedMEDICARE NUMBER
FLD55778Medicare UPIN