Provider Demographics
NPI:1770902595
Name:EPILEPSY TREATMENT CENTERS OF AMERICA
Entity type:Organization
Organization Name:EPILEPSY TREATMENT CENTERS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:SADEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-704-8380
Mailing Address - Street 1:226 W MICHIGAN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4446
Mailing Address - Country:US
Mailing Address - Phone:407-704-8380
Mailing Address - Fax:407-704-8572
Practice Address - Street 1:226 W MICHIGAN ST
Practice Address - Street 2:SUITE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4446
Practice Address - Country:US
Practice Address - Phone:407-704-8380
Practice Address - Fax:407-704-8572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97609174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty