MEDICARE: ALTAMONTE INTERNAL MEDICINE, 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	207R00000X	Internal Medicine Physician	ME28339	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	:	1831389469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTAMONTE INTERNAL MEDICINE, PA

Provider Business Mailing Address
First Line	:	616 E ALTAMONTE DR
Second Line	:	SUITE 204
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4823
Country	:	US
Telephone Number	:	407-332-7300
Fax Number	:	407-332-7086

Provider Business Practice Location Address
First Line	:	616 E ALTAMONTE DR
Second Line	:	SUITE 204
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4823
Country	:	US
Telephone Number	:	407-332-7300
Fax Number	:	407-332-7086

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RIZWAN ZAMAN
Credential	:
Telephone Number	:	407-332-7300

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	10/25/2011

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