Provider Demographics
NPI:1699414680
Name:FAMH ENTERPRISE, LLC
Entity Type:Organization
Organization Name:FAMH ENTERPRISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-417-5337
Mailing Address - Street 1:13241 BARTRAM PARK BLVD UNIT 2009
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5223
Mailing Address - Country:US
Mailing Address - Phone:833-417-5337
Mailing Address - Fax:904-930-4222
Practice Address - Street 1:13241 BARTRAM PARK BLVD UNIT 2009
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5223
Practice Address - Country:US
Practice Address - Phone:833-417-5337
Practice Address - Fax:904-930-4222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty