Provider Demographics
NPI:1356539712
Name:HAMZAH, AHMAD M (MD)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:M
Last Name:HAMZAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AHMAD
Other - Middle Name:M
Other - Last Name:HAMZAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1001 NW 13TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2269
Mailing Address - Country:US
Mailing Address - Phone:561-955-6300
Mailing Address - Fax:561-955-6310
Practice Address - Street 1:800 MEADOWS RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2304
Practice Address - Country:US
Practice Address - Phone:561-955-6300
Practice Address - Fax:561-955-6310
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42726208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064950300Medicaid
FL020050804OtherRR MEDICARE
FL020050804OtherRR MEDICARE
FL064950300Medicaid