Provider Demographics
NPI:1558857771
Name:AHMED, UMAR TALAL (OD)
Entity Type:Individual
Prefix:DR
First Name:UMAR
Middle Name:TALAL
Last Name:AHMED
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15704 ORANGE HARVEST LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3198
Mailing Address - Country:US
Mailing Address - Phone:571-236-3099
Mailing Address - Fax:
Practice Address - Street 1:11024 W COLONIAL DR STE 30
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2985
Practice Address - Country:US
Practice Address - Phone:571-236-3099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002691152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist