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General NPI Number Information
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NPI Number | 1194926501
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Entity Type | Individual
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Provider Name | KWAME SAFO NTIM MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 09/25/2015
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Provider Practice Location Address
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Address Line | 3004 17TH ST
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City | SAINT CLOUD
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State | FL
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Zip | 34769-6011
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Country | US
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Telephone | 407-593-2910
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Fax | 407-593-2913
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Provider Business Mailing Address
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Address Line | 3004 17TH STREET
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City | ST CLOUD
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State | FL
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Zip | 34769
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Country | US
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Telephone | 407-593-2910
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Fax | 407-593-2913
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME114943
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME114943
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License Number State | FL
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