Provider Demographics
NPI:1568464014
Name:ESMAILBEGUI, AHMAD (DO)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:ESMAILBEGUI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MED FAST URGENT CARE 1400 ROCKLEDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955
Mailing Address - Country:US
Mailing Address - Phone:321-242-7425
Mailing Address - Fax:
Practice Address - Street 1:MED FAST URGENT CARE 1400 ROCKLEDGE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955
Practice Address - Country:US
Practice Address - Phone:321-242-7425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S5921207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377042700Medicaid
FL80994OtherBCBS
B904SOtherBCBS
B904SOtherBCBS
FL80994OtherBCBS