Healthcare Provider Details

I. General information

NPI: 1336439660
Provider Name (Legal Business Name): SYED ADIL AFTAB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

2600 WESTHALL LN FL 4TH FLOOR
MAITLAND FL
32751-7102
US

V. Phone/Fax

Practice location:
  • Phone: 407-200-2355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME132724
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberME132724
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number036139773
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: