MEDICARE: AMERICAN ONE MEDICAL CENTER INC

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	261Q00000X	Clinic/Center	22653	FL

General Provider Information

NPI Number	:	1073754198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN ONE MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	4023 W WATERS AVE STE 14
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1948
Country	:	US
Telephone Number	:	813-886-2409
Fax Number	:	813-886-2826

Provider Business Practice Location Address
First Line	:	4023 W WATERS AVE STE 14
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1948
Country	:	US
Telephone Number	:	813-886-2409
Fax Number	:	813-886-2826

Authorized Official
Title or Position	:	GENERAL MEDICINE
Name	:	DR. NASIM AHMED
Credential	:	MD
Telephone Number	:	813-886-2409

Provider Enumeration Date	:	03/19/2009
Last Update Date	:	03/19/2009

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