Healthcare Provider Details

I. General information

NPI: 1104736149
Provider Name (Legal Business Name): AMATTA MED CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 CAMBRIDGE CT
LONGWOOD FL
32750-3901
US

IV. Provider business mailing address

635 CAMBRIDGE CT
LONGWOOD FL
32750-3901
US

V. Phone/Fax

Practice location:
  • Phone: 760-316-2441
  • Fax:
Mailing address:
  • Phone: 760-316-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: AASIYA ZAHID
Title or Position: OWNER
Credential:
Phone: 760-316-2441