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General NPI Number Information
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NPI Number | 1134547482
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Entity Type | Organization
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Legal Business Name | ALI MEDICAL CENTER INC.
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Dates
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Enumeration Date | 04/03/2014
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 2105 PALM BAY RD NE SUITE # 1
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City | PALM BAY
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State | FL
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Zip | 32905-2937
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Country | US
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Telephone | 321-676-1230
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Fax |
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Provider Business Mailing Address
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Address Line | 2105 PALM BAY RD NE SUITE 1
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City | PALM BAY
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State | FL
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Zip | 32905-2937
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Country | US
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Telephone | 321-676-1230
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SABIR ALI
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Credential | MD
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Telephone | 321-676-1230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 44893
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 62108
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License Number State | FL
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