MEDICARE: SYED T MUMTAZ MD PA

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	174400000X	Specialist	ME70936	FL

General Provider Information

NPI Number	:	1336392083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYED T MUMTAZ MD PA

Provider Business Mailing Address
First Line	:	1000 CYPRESS PKWY
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34759-3328
Country	:	US
Telephone Number	:	407-201-3944
Fax Number	:	407-201-3950

Provider Business Practice Location Address
First Line	:	1000 CYPRESS PKWY
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34759-3328
Country	:	US
Telephone Number	:	407-201-3944
Fax Number	:	407-201-3950

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. MERCEDES ACEVEDO
Credential	:
Telephone Number	:	407-944-4450

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	10/28/2008

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Directions to “SYED T MUMTAZ MD PA ” Practice Location

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