MEDICARE: ABBAS S ALI MD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1023540036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABBAS S ALI MD PLLC

Provider Business Mailing Address
First Line	:	7512 DR PHILLIPS BLVD STE 50-137
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-5420
Country	:	US
Telephone Number	:	352-843-5723
Fax Number	:	407-641-8835

Provider Business Practice Location Address
First Line	:	3190 CITRUS TOWER BLVD STE A
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6886
Country	:	US
Telephone Number	:	352-843-5723
Fax Number	:	407-641-8835

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	ABBAS S ALI
Credential	:	MD
Telephone Number	:	407-467-6604

Provider Enumeration Date	:	03/29/2017
Last Update Date	:	03/29/2017

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