Healthcare Provider Details

I. General information

NPI: 1568690733
Provider Name (Legal Business Name): ARIF UDDIN AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR
OCOEE FL
34761
US

IV. Provider business mailing address

10000 W COLONIAL DR
OCOEE FL
34761-3400
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-1378
  • Fax: 321-843-5177
Mailing address:
  • Phone: 321-843-1378
  • Fax: 321-843-5177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME136040
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: