Provider Demographics
NPI:1437140480
Name:AHMED, TANZEEN (MD)
Entity Type:Individual
Prefix:
First Name:TANZEEN
Middle Name:
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 1:14131 METROPOLIS AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4455
Mailing Address - Country:US
Mailing Address - Phone:239-986-0259
Mailing Address - Fax:239-561-8890
Practice Address - Street 1:14131 METROPOLIS AVENUE
Practice Address - Street 2:SUITE 106
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-9342
Practice Address - Country:US
Practice Address - Phone:239-561-8880
Practice Address - Fax:239-561-8890
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81543207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261192900Medicaid
FL58655ZMedicare ID - Type Unspecified
FLH43198Medicare UPIN