Abul Fazal Siddiqui

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS21326 Issued in FL

Practice address

4315 Highland Park Blvd Ste a
Lakeland, FL 33813-1639

Phone

(813) 651-1085

NPI assigned

Mar 29, 2022

Last updated

Aug 18, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Lake Erie College of Osteopathic Medicine, Bradenton, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Care Hospitalists PLGroup PAC ID 5092753632, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Florida Baptist Hospital Hospital, Plant City, FL, CCN 100132

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Care Hospitalists PL

  • Hospitalist Physician
  • Lakeland, FL
  • NPI 1457389587
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Florida Baptist Hospital Inc

  dba South Florida Baptist Hospital

  • General Acute Care Hospital
  • Plant City, FL
  • NPI 1548205883
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1356081467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 HIGHLAND PARK BLVD STE A",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131639",
            "telephone_number": "813-681-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 HIGHLAND PARK BLVD STE A",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131639",
            "telephone_number": "813-651-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ABUL",
        "middle_name": "FAZAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS21326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mario Bation Siasoyco, RN
• Severo Bation Siasoyco II, P.T.
• Juliet Sicca
• Monte R Sichelman, MD
• Atif Ahmed Siddique, DO
• Kelly E. Sidler, PTA22900
• Alexander Michael Sidor, MD
• Debbie B Sieber, LMT
• Tracy Lynn Siebold, APRN
• Siegfried K Holz MD PA (Lakeland Open MRI)

• Internal Medicine Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.