Provider Demographics
NPI:1003115098
Name:ETEMADNIA, AMIR HESAM (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:HESAM
Last Name:ETEMADNIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:460 E ALTAMONTE DR STE 2200
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4653
Mailing Address - Country:US
Mailing Address - Phone:407-767-0009
Mailing Address - Fax:407-767-0022
Practice Address - Street 1:801 MARSHALL FARMS RD
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3316
Practice Address - Country:US
Practice Address - Phone:407-767-0009
Practice Address - Fax:407-767-0022
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2024-02-25
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Provider Licenses
StateLicense IDTaxonomies
FLME 109667207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFM003ZOtherPTAN