Provider Demographics
NPI:1851635098
Name:HAMEEDI, IMRAN ALI (DMD)
Entity Type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:ALI
Last Name:HAMEEDI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 E ALTAMONTE DR
Mailing Address - Street 2:SUITE 1279
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4613
Mailing Address - Country:US
Mailing Address - Phone:407-261-0201
Mailing Address - Fax:
Practice Address - Street 1:451 E ALTAMONTE DR
Practice Address - Street 2:SUITE 1279
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4613
Practice Address - Country:US
Practice Address - Phone:407-261-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-10
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN199901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice