MEDICARE: KARIMELDIN AWAD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	ME1502033	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245718923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARIMELDIN AWAD

Provider Business Mailing Address
First Line	:	1601 W TIMBERLANE DR STE 300
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33566-0957
Country	:	US
Telephone Number	:	813-754-4611
Fax Number	:	813-443-8169

Provider Business Practice Location Address
First Line	:	1601 W TIMBERLANE DR STE 300
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33566-0957
Country	:	US
Telephone Number	:	813-754-4611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2018
Last Update Date	:	03/02/2022

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Directions to “ KARIMELDIN AWAD ” Practice Location

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