Provider Demographics
NPI:1679107064
Name:ALIAHMAD, AFTAAB (MD)
Entity Type:Individual
Prefix:
First Name:AFTAAB
Middle Name:
Last Name:ALIAHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 LEE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-5561
Mailing Address - Country:US
Mailing Address - Phone:407-732-7373
Mailing Address - Fax:407-723-4842
Practice Address - Street 1:904 LEE RD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-5561
Practice Address - Country:US
Practice Address - Phone:407-732-7373
Practice Address - Fax:407-723-4842
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162374207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBROOKDALEMedicaid