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General NPI Number Information
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NPI Number | 1679054993
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Entity Type | Organization
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Legal Business Name | IMAD TAHBUB MD LLC
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 1726 MARKHAM GLEN CIR
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City | LONGWOOD
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State | FL
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Zip | 32779-2797
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Country | US
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Telephone | 914-233-4678
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Fax |
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Provider Business Mailing Address
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Address Line | 5728 MAJOR BLVD STE 528
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City | ORLANDO
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State | FL
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Zip | 32819-7962
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Country | US
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Telephone | 914-233-4678
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | FAIZA FAISAL
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Credential |
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Telephone | 407-545-6232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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