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General NPI Number Information
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NPI Number | 1730107780
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Entity Type | Organization
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Legal Business Name | PREMCARE FAMILY MEDICAL CENTER
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 4501 S SEMORAN BLVD
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City | ORLANDO
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State | FL
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Zip | 32822-2407
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Country | US
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Telephone | 407-380-1428
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Fax | 407-380-0754
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Provider Business Mailing Address
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Address Line | 4501 S SEMORAN BLVD
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City | ORLANDO
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State | FL
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Zip | 32822-2407
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Country | US
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Telephone | 407-380-1428
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Fax | 407-380-0754
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Authorized Official
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Title or Position | MEDICINE DOCTOR
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Name | DR. MUHAMMAD A AWAN
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Credential | M.D.
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Telephone | 407-380-1428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0068874
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License Number State | FL
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