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General NPI Number Information
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NPI Number | 1104013846
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Entity Type | Organization
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Legal Business Name | ALLERGY SLEEP AND LUNG CARE PA
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 16420 HEALTHPARK COMMONS DR STE 100
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City | FORT MYERS
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State | FL
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Zip | 33908-9621
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Country | US
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Telephone | 239-437-6670
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Fax | 239-437-8871
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Provider Business Mailing Address
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Address Line | 16420 HEALTHPARK COMMONS DR STE 100
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City | FORT MYERS
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State | FL
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Zip | 33908-9621
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Country | US
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Telephone | 239-437-6670
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Fax | 239-437-8871
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Authorized Official
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Title or Position | PRESIDENT
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Name | IMTIAZ AHMAD
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Credential | MD
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Telephone | 239-437-6670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME76783
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License Number State | FL
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