Individual
EDRISS ESTIME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
290 CITRUS TOWER BLVD STE 102, CLERMONT, FL 34711-2783
(352) 404-5174
(855) 794-3370
Mailing address
290 CITRUS TOWER BLVD STE 102, CLERMONT, FL 34711-2783
(352) 404-5174
(855) 794-3370
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38260
IA
207R00000X
Internal Medicine Physician
Primary
ME112570
FL
207R00000X
Internal Medicine Physician
MT189510
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014501400
—
FL
Enumeration date
08/31/2007
Last updated
06/02/2020
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