Provider Demographics
NPI:1730156936
Name:HAIDER, ABDULLAH TAMIN (MD)
Entity type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:TAMIN
Last Name:HAIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 RIVERFRONT BLVD STE 710
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8812
Mailing Address - Country:US
Mailing Address - Phone:941-776-4000
Mailing Address - Fax:877-369-2391
Practice Address - Street 1:1312 MANATEE AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1358
Practice Address - Country:US
Practice Address - Phone:941-708-8700
Practice Address - Fax:941-708-8706
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL122085500Medicaid
FLFH102623OtherDEA LIC
FL251641100Medicaid
FL301386OtherWELLCARE URGENT CARE
FL1882193OtherMEDICARE COMPLETE
FL229615OtherAMERIGROUP URGENT CARE
FL80115985OtherRAILROAD
FLP102133OtherFREEDOM HEALTH
FL00464OtherUNIVERSAL
FLP102133OtherFREEDOM HEALTH
FL80115985OtherRAILROAD
G38383Medicare UPIN