Provider Demographics
NPI:1063609154
Name:GULE YASMEEN NAEEM MD
Entity type:Organization
Organization Name:GULE YASMEEN NAEEM MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GULE
Authorized Official - Middle Name:YASMEEN
Authorized Official - Last Name:NAEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-953-2900
Mailing Address - Street 1:1219 S EAST AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2351
Mailing Address - Country:US
Mailing Address - Phone:941-953-2900
Mailing Address - Fax:941-953-2428
Practice Address - Street 1:1219 S EAST AVE STE 102
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2351
Practice Address - Country:US
Practice Address - Phone:941-953-2900
Practice Address - Fax:941-953-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067106174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251129100Medicaid
FL2OtherPIN
FL2OtherPIN
FL251129100Medicaid