MEDICARE: AYMAN KOTEISH M.D.

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	207RT0003X	Transplant Hepatology Physician	ME120023	FL
2	207RG0100X	Gastroenterology Physician	ME120023	FL
3	207R00000X	Internal Medicine Physician	ME120023	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	:	1720035272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYMAN KOTEISH M.D.

Provider Business Mailing Address
First Line	:	2415 N ORANGE AVE
Second Line	:	SUITE 700
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-303-2474
Fax Number	:	407-303-0680

Provider Business Practice Location Address
First Line	:	2415 N ORANGE AVE
Second Line	:	SUITE 700
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-303-2474
Fax Number	:	407-303-0680

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	04/20/2016

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Directions to “ AYMAN KOTEISH M.D.” Practice Location

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