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General NPI Number Information
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NPI Number | 1609293901
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Entity Type | Individual
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Provider Name | AMIR AHMAD ALDABAGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 10875 PARK BLVD
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City | SEMINOLE
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State | FL
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Zip | 33772
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Country | US
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Telephone | 727-851-9910
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Fax | 727-851-9949
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Provider Business Mailing Address
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Address Line | 10875 PARK BLVD
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City | SEMINOLE
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State | FL
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Zip | 33772-5456
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Country | US
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Telephone | 727-393-3404
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Fax |
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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 | ME143356
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301500630
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License Number State | MI
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