Provider Demographics
NPI:1629377635
Name:DIGESTIVE DISEASE ASSOCIATES OF CENTRAL FLORIDA
Entity Type:Organization
Organization Name:DIGESTIVE DISEASE ASSOCIATES OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAEED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-994-4800
Mailing Address - Street 1:2050 ASHLEY OAKS CIR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6415
Mailing Address - Country:US
Mailing Address - Phone:813-994-4800
Mailing Address - Fax:813-994-4888
Practice Address - Street 1:2050 ASHLEY OAKS CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6415
Practice Address - Country:US
Practice Address - Phone:813-994-4800
Practice Address - Fax:813-994-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99322207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAV106ZMedicare PIN