Provider Demographics
NPI:1700281813
Name:DIABETES THYROID AND ENDOCRINE ADVANCED CARE INC
Entity Type:Organization
Organization Name:DIABETES THYROID AND ENDOCRINE ADVANCED CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-488-2555
Mailing Address - Street 1:2802 ALOMA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2802 ALOMA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3532
Practice Address - Country:US
Practice Address - Phone:407-488-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty