Provider Demographics
NPI:1801143136
Name:FLORIDA INFECTIOUS DISEASE SPECIALISTS INC.
Entity type:Organization
Organization Name:FLORIDA INFECTIOUS DISEASE SPECIALISTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOAIB
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-229-3505
Mailing Address - Street 1:10407 EMERALD WOODS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5971
Mailing Address - Country:US
Mailing Address - Phone:321-229-3505
Mailing Address - Fax:
Practice Address - Street 1:102 PARK PLACE BLVD BLDG D
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2358
Practice Address - Country:US
Practice Address - Phone:407-944-4900
Practice Address - Fax:407-483-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty