Provider Demographics
NPI:1649616152
Name:NAGI, MOHAMED MAHMOUD (MD)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:MAHMOUD
Last Name:NAGI
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 1:14100 FIVAY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7160
Mailing Address - Country:US
Mailing Address - Phone:727-992-7036
Mailing Address - Fax:
Practice Address - Street 1:14100 FIVAY RD STE 300
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7160
Practice Address - Country:US
Practice Address - Phone:727-992-7036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-12
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1571562086S0129X, 208600000X, 208G00000X
IL036152731208G00000X
390200000X
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program