Provider Demographics
NPI:1528573821
Name:AHMAD, HIRA
Entity Type:Individual
Prefix:
First Name:HIRA
Middle Name:
Last Name:AHMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5360 SW 110TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6960
Mailing Address - Country:US
Mailing Address - Phone:786-531-3439
Mailing Address - Fax:305-506-6768
Practice Address - Street 1:13397 SW 131ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5816
Practice Address - Country:US
Practice Address - Phone:786-531-3439
Practice Address - Fax:305-506-6768
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI32462355S0801X
FLSZ9810235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1528573821Medicaid