Internal Medicine Physicians of Florida LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE PHYSICIANS OF FLORIDA LLC

Practice address

4927 Van Dyke Rd
Lutz, FL 33558-4813

Phone

(813) 480-2892

Fax

(813) 428-5884

NPI assigned

Apr 4, 2019

Organization subpart

No

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

Authorized official

Name

Ihtasham Habib, MDNPI 1932374469

Title

Owner

Phone

(813) 480-2892

Specialties & licenses 1

Addresses

Other names 1

• Internal Medicine Physicians of Florida LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ihtasham Habib, MD

  • Internal Medicine Physician
  • Lutz, FL
  • NPI 1932374469
  Medicare reassignment NPD Authorized official
• Amanda J Liechty, PA-C

  • Physician Assistant
  • Wesley Chapel, FL
  • NPI 1346620069
  Medicare reassignment

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1962964254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4927 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-480-2892",
            "fax_number": "813-428-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4927 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-480-2892",
            "fax_number": "813-428-5884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10141 Big Bend Rd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335787422",
            "country_code": "US",
            "telephone_number": "813-480-2892",
            "fax_number": "813-428-5884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERNAL MEDICINE PHYSICIANS OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "HABIB",
        "authorized_official_first_name": "IHTASHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-480-2892",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine Physicians of Florida LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Internal Medicine Physicians of Florida LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Lutz, FL
• Providers in Lutz, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.