Healthcare Provider Details

I. General information

NPI: 1194346510
Provider Name (Legal Business Name): INTEAM HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11977 S APOPKA VINELAND RD
ORLANDO FL
32836-7025
US

IV. Provider business mailing address

10849 EMERALD CHASE DR
ORLANDO FL
32836-5881
US

V. Phone/Fax

Practice location:
  • Phone: 863-458-0579
  • Fax:
Mailing address:
  • Phone: 863-458-0579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHEIKH K JASIMUDDIN
Title or Position: PRESIDENT
Credential: MD
Phone: 863-458-0579