| Internal Medicine Physicians Of Florida Llc | |
|
4927 Van Dyke Rd Lutz FL 33558-4813 | |
| (813) 480-2892 | |
| (813) 428-5884 |
| Full Name | Internal Medicine Physicians Of Florida Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4927 Van Dyke Rd, Lutz, Florida |
| Authorized Official Name and Position | Ihtasham Habib (OWNER) |
| Authorized Official Contact | 8134802892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Physicians Of Florida Llc 4927 Van Dyke Rd Lutz FL 33558-4813 Ph: (813) 480-2892 | Internal Medicine Physicians Of Florida Llc 4927 Van Dyke Rd Lutz FL 33558-4813 Ph: (813) 480-2892 |
| NPI Number | 1962964254 |
|---|---|
| Provider Enumeration Date | 04/04/2019 |
| Last Update Date | 03/26/2021 |
| Medicare PECOS PAC ID | 0648504837 |
|---|---|
| Medicare Enrollment ID | O20190621000517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962964254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ihtasham Habib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932374469 PECOS PAC ID: 5193887990 Enrollment ID: I20111116000942 |
| Provider Name | Kara Lee Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740047414 PECOS PAC ID: 5395181515 Enrollment ID: I20240311002346 |
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