Individual
ATTIYA ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2105 PALM BAY RD. NE, SUITE 3, PALM BAY, FL 32905-2937
(321) 984-8808
(321) 676-7011
Mailing address
2105 PALM BAY RD NE STE 3, PALM BAY, FL 32905-2937
(321) 984-8808
(321) 676-7011
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ME0062108
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
224328
AMERIGROUP
FL
01
—
23941
BCBS
FL
05
—
373757800
—
FL
01
—
4399726
AETNA
FL
Enumeration date
08/29/2006
Last updated
09/24/2021
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