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BASIMA MUHAMMED ABDUL-RAZAK MD
>> Pediatrics >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1346279460
Individual Registrant: BASIMA MUHAMMED ABDUL-RAZAK MD
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
601 E ROLLINS ST ORLANDO, FL 32803 US
Tel: 407-975-0412 Fax: 407-975-0413
Tel: 407-975-0412 Fax: 407-975-0413
Contact information for business:
601 E ROLLINS ST ORLANDO, FL 32803-1248 US
Tel: 407-975-0412 Fax: 407-975-0413
Tel: 407-975-0412 Fax: 407-975-0413
Registration Information:
NPI: 1346279460
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | CA | C53991 |
| N | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | MI | 4301068389 |
| N | 208M00000X | Allopathic & Osteopathic Physicians Hospitalist | FL | ME134057 |
| Y | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | FL | ME134057 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| GREAT LAKES HEALTH PLAN# | 146412 | 01 | |
| MCARE PIN # | 16528 | 01 | |
| 4673447-10 | MI | 05 | |
| 4331048-10 | MI | 05 | |
| CAPE PIN NUMBER | 00000005503A | 01 | |
| MIDWEST PIN # | 023862 | 01 | |
| AETNA PROVIDER NUMBER | 7686102 | 01 | |
| BCBS/BCN PIN NUMBER | 0634484 | 01 | |
| HEALTH PLAN OF MICHIGAN# | 16502 | 01 |
