Provider Demographics
NPI:1598061905
Name:AHMAD B AMAWI, PA
Entity Type:Organization
Organization Name:AHMAD B AMAWI, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-647-2550
Mailing Address - Street 1:PO BOX 180898
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32718-0898
Mailing Address - Country:US
Mailing Address - Phone:407-647-2550
Mailing Address - Fax:
Practice Address - Street 1:5745 CANTON CV STE 121
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5012
Practice Address - Country:US
Practice Address - Phone:407-647-2550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty