MOHAMMAD ALI FAISAL, M.D., P.A. (NPI# 1689639353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689639353 |
| Entity Type | Organization |
| Organization Name | MOHAMMAD ALI FAISAL, M.D., P.A. |
| Practice Address |
1283 Sw State Road 47 Suite 104 Lake City FL 32025-0490 |
| Mailing Address |
Po Box 3009 Lake City FL 32056-3009 |
| Practice Telephone | 3867585985 |
| Practice Fax Number | 3867585987 |
| Mailing Telephone | 3867585985 |
| Mailing Fax Number | 3867585987 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2014-05-19 |
| Authorized Official Name | DR. MOHAMMAD ALI FAISAL (PRESIDENT) |
| Authorized Official Telephone | 3867585985 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ME58587 | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 251378100 | 05 | |
| FL | BCBS | 21142 | 01 |
| Street Address |
1283 SW STATE ROAD 47 SUITE 104 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025-0490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801866405 | Mohammad A Faisal | Internal Medicine | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2006-01-25 |
| 1174063127 | Nicole Polbos | Nurse Practitioner | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2017-02-24 |
| 1023453222 | Begum Internal Medicine LLC | Legal Medicine | 1283 Sw State Road 47, Suite 101, Lake City, FL 32025-0489 | 2013-05-02 |
| 1366680357 | Tohmina Begum | Internal Medicine | 1283 Sw State Road 47, Suite 101, Lake City, FL 32025-0489 | 2009-01-28 |
| 1174719629 | Raimah Primary Care Center Pa | Family Medicine | 1283 Sw State Road 47, 103, Lake City, FL 32025-0489 | 2007-09-19 |
| 1407884018 | Marie Raime | Family Medicine | 1283 Sw State Road 47, Suite 103, Lake City, FL 32025-0489 | 2006-06-30 |
| 1629048228 | Ricardo J Rosado | Internal Medicine | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| 1437579372 | Shara Evans | Specialist | 501 Nw Lake City Ave, Apt 103, Lake City, FL 32055 | 2014-04-18 |
| 1073959136 | Vernon Taylor Smith | Specialist | 2537 Elk Road, Lake City, CO 81235 | 2013-05-16 |
| 1346478989 | Tiffani Mote | Specialist | 315 Sw Pheasant Way, Lake City, FL 32024-1146 | 2009-06-22 |
| 1972790517 | Jorga Snyder Duran | Specialist | 214 Se Tribble St, Lake City, FL 32025-0108 | 2007-09-27 |
| 1326239179 | Michelle Caroline Hatton | Specialist | 4852 S Us Highway 441, Lake City, FL 32025-0310 | 2007-08-07 |
| 1023210986 | North Fl Arthritis Clinic, Pa. | Specialist | 4551 W Est Us 90, Suite 102, Lake City, FL 32055 | 2007-06-04 |
| 1023102555 | Pastor H. Rios, Md | Specialist | 449 Se Baya Drive, Lake City, FL 32025 | 2006-10-02 |
| 1447352760 | Juan R Baralt | Specialist | 619 South Marion, Lake City, FL 32025-5808 | 2006-09-05 |
| 1457376055 | William Clark Griggs | Specialist | 238 East Main Street, Lake City, SC 29560 | 2006-07-13 |
| Find all providers in LAKE CITY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.