Provider Demographics
NPI:1104804525
Name:EL RIMAWI, NIDAL (MD,MSC)
Entity type:Individual
Prefix:DR
First Name:NIDAL
Middle Name:
Last Name:EL RIMAWI
Suffix:
Gender:M
Credentials:MD,MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 FOWLER GROVE BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5597
Mailing Address - Country:US
Mailing Address - Phone:407-614-0528
Mailing Address - Fax:407-614-0529
Practice Address - Street 1:2200 FOWLER GROVE BLVD STE 140
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5597
Practice Address - Country:US
Practice Address - Phone:407-614-0528
Practice Address - Fax:407-614-0529
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259479207Q00000X
FLME81222207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL124795800Medicaid
99388OtherMEDICARE GROUP ASSOCIATED PTAN
FL01528YOtherMEDICARE PTAN
FLG95774Medicare UPIN
01528ZMedicare PIN