Provider Demographics
NPI:1467039065
Name:AMJAD, UZAIR
Entity type:Individual
Prefix:
First Name:UZAIR
Middle Name:
Last Name:AMJAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 RED BUG LAKE RD STE 2030
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6838
Mailing Address - Country:US
Mailing Address - Phone:407-706-1234
Mailing Address - Fax:
Practice Address - Street 1:8400 RED BUG LAKE RD STE 2030
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6838
Practice Address - Country:US
Practice Address - Phone:407-706-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-28
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4583213ES0103X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program