MEDICARE: ORLANDO INFECTIOUS DISEASE CONSULTANCY SERVICES PL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME88164	FL
2	207RI0200X	Infectious Disease Physician	ME88164	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DF5048	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881769685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLANDO INFECTIOUS DISEASE CONSULTANCY SERVICES PL

Provider Business Mailing Address
First Line	:	4156 BROOKMYRA DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-5109
Country	:	US
Telephone Number	:	321-228-0073
Fax Number	:	407-350-5928

Provider Business Practice Location Address
First Line	:	1182 CYPRESS GLEN CIR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-7560
Country	:	US
Telephone Number	:	407-350-5917
Fax Number	:	407-350-5928

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARIAM ADAM ESAT
Credential	:	M.D.
Telephone Number	:	407-350-5917

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	12/26/2014

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Directions to “ORLANDO INFECTIOUS DISEASE CONSULTANCY SERVICES PL ” Practice Location

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