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Organization

BORN AGAIN DOCTOR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUALEH ASHRAF MD (OWNER)
(407) 645-1847
Entity
Organization

Contact information

Practice address
10671 EMERALD CHASE DR, ORLANDO, FL 32836-5855
(407) 645-1847
(407) 978-6507
Mailing address
10671 EMERALD CHASE DR, ORLANDO, FL 32836-5855
(407) 645-1847
(407) 978-6507

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME83798
FL
207RC0000X
Cardiovascular Disease Physician
ME83798
FL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME83798
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME83798
FLORIDA MEDICAL LICENSE
FL
Enumeration date
12/04/2015
Last updated
12/04/2015
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