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DR. IMRAAN ANSAARIE MD
Interventional Cardiology >> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1972714632
Individual Registrant:DR. IMRAAN ANSAARIE MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
215 HWY 17S EAST PALATKA, FL 32131 US
Tel: 773-412-3420 Fax: --
Tel: 773-412-3420 Fax: --
Contact information for business:
209 PINEHURST POINTE DR ST AUGUSTINE, FL 32092-3703 US
Tel: 773-412-3420 Fax: --
Tel: 773-412-3420 Fax: --
Registration Information:
NPI: 1972714632
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207RI0011X | Allopathic & Osteopathic Physicians Internal Medicine Interventional Cardiology | FL | ME121178 |
| N | 207RC0000X | Allopathic & Osteopathic Physicians Internal Medicine | FL | ME121178 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 012828200 | FL | 05 | |
| 200902590 | IN | 05 |
