Provider Demographics
NPI:1174934434
Name:QURESHI, MOHAMMED AALY (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:AALY
Last Name:QURESHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY # WAYD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-1474
Mailing Address - Fax:954-385-6026
Practice Address - Street 1:17180 ROYAL PALM BLVD STE 1
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2394
Practice Address - Country:US
Practice Address - Phone:954-276-1474
Practice Address - Fax:954-385-6026
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME1362172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program