Provider Demographics
NPI:1255812418
Name:HAMID, MOHAMMED 'MARK' A
Entity type:Individual
Prefix:
First Name:MOHAMMED 'MARK'
Middle Name:A
Last Name:HAMID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30268 SOUTHERNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-4010
Mailing Address - Country:US
Mailing Address - Phone:804-557-0507
Mailing Address - Fax:
Practice Address - Street 1:20701 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3676
Practice Address - Country:US
Practice Address - Phone:804-557-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty