Provider Demographics
NPI:1063841567
Name:POINCIANA INTERNAL MEDICINE PA
Entity Type:Organization
Organization Name:POINCIANA INTERNAL MEDICINE PA
Other - Org Name:OCOEE INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:026-798-2244
Mailing Address - Street 1:1144 KELTON AVE STE 1009
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3175
Mailing Address - Country:US
Mailing Address - Phone:407-553-8030
Mailing Address - Fax:407-533-8035
Practice Address - Street 1:1144 KELTON AVE STE 1009
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3175
Practice Address - Country:US
Practice Address - Phone:075-538-0304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty