Provider Demographics
NPI:1659757755
Name:SOUTH FLORIDA INTERNAL MEDICINE PLLC
Entity type:Organization
Organization Name:SOUTH FLORIDA INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRAJ
Authorized Official - Middle Name:V
Authorized Official - Last Name:TIRMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:240-389-1986
Mailing Address - Street 1:3905 NATIONAL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-6106
Mailing Address - Country:US
Mailing Address - Phone:240-389-1986
Mailing Address - Fax:833-449-5686
Practice Address - Street 1:3905 NATIONAL DR STE 220
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-6106
Practice Address - Country:US
Practice Address - Phone:240-389-1986
Practice Address - Fax:833-449-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102836208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty