Provider Demographics
NPI:1316904576
Name:CHOUDHRY, MOHAMMED AFZAL (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:AFZAL
Last Name:CHOUDHRY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:26218 US HIGHWAY 27
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-1707
Mailing Address - Country:US
Mailing Address - Phone:352-323-1758
Mailing Address - Fax:352-323-1894
Practice Address - Street 1:26218 US HIGHWAY 27
Practice Address - Street 2:SUITE 105
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-1707
Practice Address - Country:US
Practice Address - Phone:352-323-1758
Practice Address - Fax:352-323-1894
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME86954174400000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG83879Medicare UPIN