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DR. MOHAMMAD BASIL AMIN M.D
Addiction Medicine >> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1104881101
Individual Registrant:DR. MOHAMMAD BASIL AMIN M.D
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
205 ZEAGLER DR. SUITE # 401-B PALATKA, FL 32177 US
Tel: 386-325-8482 Fax: 386-325-3512
Tel: 386-325-8482 Fax: 386-325-3512
Contact information for business:
PO BOX 2468 PALATKA, FL 32177 US
Tel: 386-325-8482 Fax: 386-325-3512
Tel: 386-325-8482 Fax: 386-325-3512
Registration Information:
NPI: 1104881101
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207RA0401X | Allopathic & Osteopathic Physicians Internal Medicine Addiction Medicine | FL | ME0072588 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 261232100 | FL | 05 |
