Provider Demographics
NPI:1194895243
Name:MIR, TANVEER P (MD)
Entity type:Individual
Prefix:
First Name:TANVEER
Middle Name:P
Last Name:MIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4603
Mailing Address - Country:US
Mailing Address - Phone:407-303-2906
Mailing Address - Fax:407-303-7126
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4603
Practice Address - Country:US
Practice Address - Phone:407-303-2906
Practice Address - Fax:407-303-7126
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2015-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 125740207RG0300X, 207RH0002X
NY179063207RG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF73069Medicare UPIN