Healthcare Provider Details

I. General information

NPI: 1487385126
Provider Name (Legal Business Name): AFTAB AKHTAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 06/23/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 EDGEWATER DR # 5300
ORLANDO FL
32804-6350
US

IV. Provider business mailing address

1317 EDGEWATER DR # 5300
ORLANDO FL
32804-6350
US

V. Phone/Fax

Practice location:
  • Phone: 305-735-2452
  • Fax:
Mailing address:
  • Phone: 305-735-2452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number26172-P
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: