Provider Demographics
NPI:1215963897
Name:LATIF, NASEEM BANO (MD)
Entity type:Individual
Prefix:
First Name:NASEEM
Middle Name:BANO
Last Name:LATIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NASEEM
Other - Middle Name:BANO
Other - Last Name:LATIF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2306 LEE RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789
Mailing Address - Country:US
Mailing Address - Phone:407-629-0705
Mailing Address - Fax:407-629-5285
Practice Address - Street 1:2306 LEE RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789
Practice Address - Country:US
Practice Address - Phone:407-629-0705
Practice Address - Fax:407-629-5285
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0031829207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL039672900Medicaid