Provider Demographics
NPI:1609885680
Name:INTERNAL MEDICINE CLINIC PA
Entity Type:Organization
Organization Name:INTERNAL MEDICINE CLINIC PA
Other - Org Name:ABBEY PRIME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-684-2929
Mailing Address - Street 1:8355 NORTHCLIFFE BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1139
Mailing Address - Country:US
Mailing Address - Phone:352-684-2929
Mailing Address - Fax:352-684-2929
Practice Address - Street 1:8355 NORTHCLIFFE BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1139
Practice Address - Country:US
Practice Address - Phone:352-684-2929
Practice Address - Fax:352-684-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81153 / ME0069703207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty