Provider Demographics
NPI:1376830109
Name:AHMED, JUNAID ABDUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JUNAID
Middle Name:ABDUL
Last Name:AHMED
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 1:8773 PERIMETER PARK CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1165
Mailing Address - Country:US
Mailing Address - Phone:904-493-3390
Mailing Address - Fax:904-493-3395
Practice Address - Street 1:7807 BAYMEADOWS RD E
Practice Address - Street 2:SUITE 209
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9664
Practice Address - Country:US
Practice Address - Phone:904-330-1024
Practice Address - Fax:904-330-1027
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 113367207R00000X
TXS8950207RC0000X
IL336.083667207RC0000X
WAMD61068195207RC0000X
IN01084604A207RC0000X
MO2021009894207RC0000X
FLME113367207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL356965OtherAVMED
FL004XPOtherFLORIDA BLUE - GROUP
FL0063488-00Medicaid
FL0103467-00OtherFL MEDICAID - GROUP
WA2173912Medicaid
FL9485883OtherAETNA
FLHR822AOtherFL MEDICARE - GROUP
FL4463627OtherCIGNA
GA003129995AOtherGEORGIA MEDICAID
FLDU5524OtherRR MEDICARE - GROUP
FL785407OtherWELLCARE
FL14M11OtherFLORIDA BLUE - INDIVIDUAL
FLPO1153907OtherRR MEDICARE - INDIVIDUAL