Individual provider Active NPI

Ghazala T Mumtaz, MD

  • Internal Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1417973678
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME93344 Issued in FL
Practice address
724 W Vine St
Kissimmee, FL 34741-4161
Phone
(407) 944-4450
Fax
(407) 944-1858
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME93344 FL Primary

Addresses

Primary practice location

724 W Vine St
Kissimmee, FL 34741-4161

Mailing address

724 W Vine Street
Kissimmee, FL 34741-4931
Phone (407) 944-4450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051027000415 FL Practitioner - Internal Medicine 4385661545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Syed Tariq Mumtaz M D P a CurrentSince Dec 23, 2012 Accepting new patients

Locations

724 W Vine St
Kissimmee, FL 34741
Phone (407) 201-3944

1000 Cypress Pkwy
Kissimmee, FL 34759
Phone (407) 201-3944

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1417973678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 W VINE STREET",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414931",
            "telephone_number": "407-944-4450",
            "fax_number": "407-944-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 W VINE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414161",
            "telephone_number": "407-944-4450",
            "fax_number": "407-944-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMTAZ",
        "first_name": "GHAZALA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME93344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.