Provider Demographics
NPI:1720087711
Name:ASLAM, MUHAMMAD IRFAN (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:IRFAN
Last Name:ASLAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:95 BULLDOG BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3332
Mailing Address - Country:US
Mailing Address - Phone:321-727-2990
Mailing Address - Fax:321-724-0455
Practice Address - Street 1:6100 MINTON RD NW
Practice Address - Street 2:SUITE 103B
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-1900
Practice Address - Country:US
Practice Address - Phone:321-308-5111
Practice Address - Fax:321-308-5114
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101181207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
02/01/2009OtherBEECHSTREET
FL000074800Medicaid
05/15/2008OtherEVOLUTIONS
FL08/04/2008OtherUNITEDHEALTHCARE
8016391OtherCIGNA
11/07/2008OtherMULTIPLAN/PHCS
7401308OtherAETNA
01/01/2009OtherACCOUNTABLE/INTERPLANHEALTHGROUP
FL08/26/2008OtherTRICARE
PR06492OtherQUALITYHEALTHPLAN
08/01/2008OtherNPPN/COALITION AMERICA
07/10/2008OtherGREAT WEST
FL1068054OtherCAREPLUS
FL31861OtherBCBS OF FL
FL453272OtherWELLCARE HEALTH PLAN
FL01226785OtherAMERIGROUP
01/09/2009OtherCOVENTRY
FL000074800Medicaid
FL1068054OtherCAREPLUS