Provider Demographics
NPI:1881973147
Name:ALI, MUNSIF (MD)
Entity type:Individual
Prefix:DR
First Name:MUNSIF
Middle Name:
Last Name:ALI
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 1:600 VINCENT WAY APT 2202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3349
Mailing Address - Country:US
Mailing Address - Phone:773-565-8674
Mailing Address - Fax:352-385-0033
Practice Address - Street 1:18550 US HIGHWAY 441
Practice Address - Street 2:SUITE A
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6751
Practice Address - Country:US
Practice Address - Phone:352-735-3755
Practice Address - Fax:352-385-0033
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111803207R00000X
KY48453207R00000X, 208M00000X
IL036.139108207R00000X
MI5315078849207R00000X
ALMD.41475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG1611ZOtherMEDICARE
14MJ8OtherBCBS FLORIDA
FL006552700Medicaid