Provider Demographics
NPI:1134515687
Name:ELBEDEWY, AHMED MOHAMED MOHSEN (MD, FAAP)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:MOHAMED MOHSEN
Last Name:ELBEDEWY
Suffix:
Gender:M
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-254-5920
Mailing Address - Fax:239-254-5921
Practice Address - Street 1:3361 PINE RIDGE RD STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-3937
Practice Address - Country:US
Practice Address - Phone:239-254-5920
Practice Address - Fax:239-254-5921
Is Sole Proprietor?:No
Enumeration Date:2015-04-11
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY294636-1208000000X
FLME146403208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110385000Medicaid