Provider Demographics
NPI:1891727442
Name:AHMAD, NAZEEL (MD)
Entity Type:Individual
Prefix:
First Name:NAZEEL
Middle Name:
Last Name:AHMAD
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 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:LABORATORY SVC-113
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-972-2000
Mailing Address - Fax:813-978-5827
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:LABORATORY SVC-113
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:813-978-5827
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74332207ZC0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35989OtherBLUE CROSS BLUE SHIELD
FL259805100Medicaid
FL35989YMedicare ID - Type Unspecified
FL35989OtherBLUE CROSS BLUE SHIELD