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General NPI Number Information
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NPI Number | 1609836089
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Entity Type | Individual
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Provider Name | IVAN FOSTER ACKERMAN M.D
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Gender | Male
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 12/15/2009
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Provider Practice Location Address
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Address Line | 402 NOLAND DR
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City | BRANDON
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State | FL
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Zip | 33511-5709
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Country | US
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Telephone | 813-655-9000
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Fax | 813-655-7344
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Provider Business Mailing Address
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Address Line | 402 NOLAND DR
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City | BRANDON
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State | FL
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Zip | 33511-5709
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Country | US
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Telephone | 813-655-9000
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Fax | 813-655-7344
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME48711
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License Number State | FL
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