Provider Demographics
NPI:1639121833
Name:AHMED, MUJAHED MAQBOOL (MD)
Entity Type:Individual
Prefix:DR
First Name:MUJAHED
Middle Name:MAQBOOL
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MUJAHED
Other - Middle Name:M
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3098 FOREST HILL BLVD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5940
Mailing Address - Country:US
Mailing Address - Phone:561-968-7600
Mailing Address - Fax:561-968-0443
Practice Address - Street 1:3098 FOREST HILL BLVD UNIT 1
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-5940
Practice Address - Country:US
Practice Address - Phone:561-968-7600
Practice Address - Fax:561-968-0443
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61806207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15075BMedicare ID - Type Unspecified