Provider Demographics
NPI:1093266041
Name:MOHAMMAD SHAHMOHAMADY MDPA
Entity Type:Organization
Organization Name:MOHAMMAD SHAHMOHAMADY MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHMOHAMADY
Authorized Official - Suffix:
Authorized Official - Credentials:M,D,
Authorized Official - Phone:305-247-1100
Mailing Address - Street 1:PO BOX 862206
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-2206
Mailing Address - Country:US
Mailing Address - Phone:305-380-1626
Mailing Address - Fax:305-386-1635
Practice Address - Street 1:975 BAPTIST WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7600
Practice Address - Country:US
Practice Address - Phone:305-247-1100
Practice Address - Fax:305-245-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty