Provider Demographics
NPI:1386693398
Name:MUQEEM, MOHAMMED A (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:A
Last Name:MUQEEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8820 BAY VILLA CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5832
Mailing Address - Country:US
Mailing Address - Phone:407-892-1786
Mailing Address - Fax:
Practice Address - Street 1:505 N JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4905
Practice Address - Country:US
Practice Address - Phone:407-846-2786
Practice Address - Fax:866-890-0786
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93005207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273778700Medicaid
FLU6102ZMedicare ID - Type Unspecified
FL273778700Medicaid