Provider Demographics
NPI:1831419753
Name:HAFEEZ, ANITA FATIMA (DO)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:FATIMA
Last Name:HAFEEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9113 PECKY CYPRESS WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-6563
Mailing Address - Country:US
Mailing Address - Phone:248-703-5338
Mailing Address - Fax:
Practice Address - Street 1:7975 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8202
Practice Address - Country:US
Practice Address - Phone:407-303-6830
Practice Address - Fax:407-303-6839
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine