Provider Demographics
NPI:1417947854
Name:ASAD, ALIYA (MD)
Entity type:Individual
Prefix:
First Name:ALIYA
Middle Name:
Last Name:ASAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 W COPANS RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7747
Mailing Address - Country:US
Mailing Address - Phone:954-975-4611
Mailing Address - Fax:954-975-4079
Practice Address - Street 1:5100 W COPANS RD
Practice Address - Street 2:SUITE 800
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-7747
Practice Address - Country:US
Practice Address - Phone:954-975-4611
Practice Address - Fax:954-975-4079
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME83289208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265466100Medicaid