Provider Demographics
NPI:1134515687
Name:ELBEDEWY, AHMED MOHAMED MOHSEN (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:MOHAMED MOHSEN
Last Name:ELBEDEWY
Suffix:
Gender:M
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:954-431-8000
Mailing Address - Fax:954-436-0449
Practice Address - Street 1:400 N HIATUS RD STE 105
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5214
Practice Address - Country:US
Practice Address - Phone:954-431-8000
Practice Address - Fax:954-436-0449
Is Sole Proprietor?:No
Enumeration Date:2015-04-11
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY294636-1208000000X
FLME146403208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110385000Medicaid