Healthcare Provider Details

I. General information

NPI: 1417406208
Provider Name (Legal Business Name): US TELEMED SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 MASSACHUSETTS AVE
NEW PORT RICHEY FL
34653-3024
US

IV. Provider business mailing address

7700 MASSACHUSETTS AVE
NEW PORT RICHEY FL
34653-3024
US

V. Phone/Fax

Practice location:
  • Phone: 727-848-2273
  • Fax:
Mailing address:
  • Phone: 727-848-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number124365-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME50383
License Number StateFL

VIII. Authorized Official

Name: DR. ARAIN MOHAMMED NAWAZ
Title or Position: PRESIDENT
Credential: MD
Phone: 727-848-6337