| Organization Name: | GULF COAST INTERNAL MEDICINE PA |
| NPI Number: | 1114125606 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TANZEEN AHMED (OWNER) |
| Mailing Address: | 14131 Metropolis Avenue Suite 106 Fort Myers |
| State: | FL US |
| Postal Code: | 339129383 |
| Phone Number: | 2395618880 |
| Fax Number: | 2395618890 |
| NPI Enumeration Date: | 07/05/2007 |
| NPI Last Update Date: | 01/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | ME81543 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |