Provider Demographics
NPI:1093033433
Name:HAMEEDI, AMIR ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:ALI
Last Name:HAMEEDI
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 1:734 N 3RD ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5285
Mailing Address - Country:US
Mailing Address - Phone:352-365-2583
Mailing Address - Fax:
Practice Address - Street 1:801 E DIXIE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7699
Practice Address - Country:US
Practice Address - Phone:352-365-2583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1223772085B0100X, 2085D0003X, 2085N0904X, 2085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014925700Medicaid