Provider Demographics
NPI:1639221260
Name:AHMED, OSMAN I (MD)
Entity Type:Individual
Prefix:
First Name:OSMAN
Middle Name:I
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7146
Mailing Address - Country:US
Mailing Address - Phone:727-820-7778
Mailing Address - Fax:727-820-7779
Practice Address - Street 1:2191 9TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7146
Practice Address - Country:US
Practice Address - Phone:727-820-7778
Practice Address - Fax:727-820-7779
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 59458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine