Provider Demographics
NPI:1225007321
Name:AHMAD, NAVEED (MD)
Entity Type:Individual
Prefix:
First Name:NAVEED
Middle Name:
Last Name:AHMAD
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 1:401 PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA
Mailing Address - State:FL
Mailing Address - Zip Code:32168-7322
Mailing Address - Country:US
Mailing Address - Phone:386-424-5140
Mailing Address - Fax:
Practice Address - Street 1:401 PALMETTO ST
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-7322
Practice Address - Country:US
Practice Address - Phone:386-424-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1105592085R0202X
FLME934202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI25063Medicare UPIN