MEDICARE: INTERNAL MEDICINE CLINIC

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	183500000X	Pharmacist	ME0069703	FL

General Provider Information

NPI Number	:	1225454671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNAL MEDICINE CLINIC

Provider Business Mailing Address
First Line	:	2210 E HILLSBOROUGH AVE
Second Line	:	UNIT#6
City	:	TAMPA
State	:	FL
Zip	:	33610-4450
Country	:	US
Telephone Number	:	813-237-2090
Fax Number	:	352-684-2646

Provider Business Practice Location Address
First Line	:	2210 E HILLSBOROUGH AVE
Second Line	:	UNIT#6
City	:	TAMPA
State	:	FL
Zip	:	33610-4450
Country	:	US
Telephone Number	:	813-237-2090
Fax Number	:	352-684-2646

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AYMAN OSMAN
Credential	:	MD
Telephone Number	:	352-684-2929

Provider Enumeration Date	:	03/10/2014
Last Update Date	:	03/10/2014

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