Born Again Doctor LLC
Internal Medicine, Endocrinology, Diabetes & Metabolism in Orlando, FL. Organization (NPI-2).
NPI number1821463688
StatusActive
Last updated in NPPESDec 4, 2015
Details
- NPI
- 1821463688
- Entity type
- Organization (NPI-2)
- Legal business name
- Born Again Doctor LLC
- Organization subpart
- No
- Enumeration date
- Dec 4, 2015
- Last updated
- Dec 4, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RE0101X | Internal Medicine, Endocrinology, Diabetes & Metabolism | ME83798 | FL | Yes |
| 207R00000X | Internal Medicine | ME83798 | FL | |
| 207RC0000X | Internal Medicine, Cardiovascular Disease | ME83798 | FL |
Practice location
10671 Emerald Chase DrOrlando, FL 32836-5855
Phone 407-645-1847 · Fax 407-978-6507
Mailing address
10671 Emerald Chase DrOrlando, FL 32836-5855
Phone 407-645-1847 · Fax 407-978-6507
Authorized official
Sualeh Ashraf
Owner
4076451847
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