Organization
SYED TARIQ MUMTAZ MD PA
Active
Parent organization
MEDVANTX, INC.
Other names
Mumtaz Medical Associates- Poinciana
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
1000 CYPRESS PKWY, KISSIMMEE, FL 34759-3328
(407) 201-3944
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME70936
FL
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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