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General NPI Number Information
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NPI Number | 1639584709
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Entity Type | Individual
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Provider Name | MEKDES DITAMO D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 76 UNDERWOOD ST STE 200
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City | ORLANDO
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State | FL
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Zip | 32806-1110
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Country | US
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Telephone | 321-841-2800
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Fax | 321-843-8777
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Provider Business Mailing Address
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Address Line | 76 UNDERWOOD ST # MP67
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City | ORLANDO
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State | FL
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Zip | 32806-1110
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Country | US
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Telephone | 321-843-7103
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Fax | 321-843-8777
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | OS14666
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | DO01407
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License Number State | RI
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