Provider Demographics
NPI:1619976198
Name:AHMED, MAHMUD U (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHMUD
Middle Name:U
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MAHMUD
Other - Middle Name:U
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:117 W BELT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BUSHNELL
Mailing Address - State:FL
Mailing Address - Zip Code:33513-5105
Mailing Address - Country:US
Mailing Address - Phone:352-568-1988
Mailing Address - Fax:352-568-2427
Practice Address - Street 1:117 W BELT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BUSHNELL
Practice Address - State:FL
Practice Address - Zip Code:33513-5105
Practice Address - Country:US
Practice Address - Phone:352-568-1988
Practice Address - Fax:352-568-2427
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066026207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376013800Medicaid
FL25494YMedicare PIN
FL25494ZMedicare PIN
FL376013800Medicaid
FL25494UMedicare PIN