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General NPI Number Information
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NPI Number | 1639129133
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Entity Type | Individual
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Provider Name | ABDUL KADER EZELDIN MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 2400 N ORANGE BLOSSOM TRL STE 204
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City | KISSIMMEE
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State | FL
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Zip | 34744-2307
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Country | US
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Telephone | 407-894-4474
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 N ORANGE BLOSSOM TRL STE 204
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City | KISSIMMEE
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State | FL
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Zip | 34744-2307
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Country | US
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Telephone | 407-894-4474
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | E3462
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME151263
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License Number State | FL
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