Provider Demographics
NPI:1134126535
Name:AHMED, TAMER S (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMER
Middle Name:S
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 E HIBISCUS BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3102
Mailing Address - Country:US
Mailing Address - Phone:321-768-3655
Mailing Address - Fax:321-831-3024
Practice Address - Street 1:111 E HIBISCUS BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3102
Practice Address - Country:US
Practice Address - Phone:321-768-3655
Practice Address - Fax:321-831-3024
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83010207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269037300Medicaid
FL03019TMedicare PIN
FLH46818Medicare UPIN