Provider Demographics
NPI:1396778510
Name:ATILLA, MEHMET AYDIN (MD)
Entity type:Individual
Prefix:DR
First Name:MEHMET
Middle Name:AYDIN
Last Name:ATILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 12TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4084
Mailing Address - Country:US
Mailing Address - Phone:305-295-3535
Mailing Address - Fax:305-294-6868
Practice Address - Street 1:1111 12TH ST STE 103
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4084
Practice Address - Country:US
Practice Address - Phone:305-295-3535
Practice Address - Fax:305-294-6868
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700180207R00000X, 208000000X
FL97117207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901960Medicaid
NC10810OtherBCBS
FLFV342AOtherMEDICARE GROUP PTAN
FLFH596YOtherMEDICARE INDIVIDUAL PTAN
NC1467405431OtherGROUP NPI NUMBER
NC8910810Medicaid
NC01960OtherBCBS GROUP NUMBER
FLFV342AOtherMEDICARE GROUP PTAN
NC1467405431OtherGROUP NPI NUMBER