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General NPI Number Information
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NPI Number | 1821463688
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Entity Type | Organization
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Legal Business Name | BORN AGAIN DOCTOR LLC
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Dates
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Enumeration Date | 12/04/2015
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 10671 EMERALD CHASE DR
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City | ORLANDO
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State | FL
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Zip | 32836-5855
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Country | US
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Telephone | 407-645-1847
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Fax | 407-978-6507
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Provider Business Mailing Address
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Address Line | 10671 EMERALD CHASE DR
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City | ORLANDO
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State | FL
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Zip | 32836-5855
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Country | US
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Telephone | 407-645-1847
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Fax | 407-978-6507
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUALEH ASHRAF
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Credential | MD
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Telephone | 407-645-1847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME83798
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME83798
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME83798
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License Number State | FL
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