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General NPI Number Information
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NPI Number | 1902223696
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Entity Type | Organization
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Legal Business Name | SURGIMED OF ORLANDO LLC
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Dates
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Enumeration Date | 03/19/2014
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 631 PALM SPRINGS DR STE 104
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-7854
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Country | US
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Telephone | 407-966-3355
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 149735
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City | ORLANDO
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State | FL
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Zip | 32814-9735
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Country | US
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Telephone | 407-966-3355
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AFAQ ZAMAN KHAN
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Credential | M.D.
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Telephone | 407-966-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME111455
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License Number State | FL
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