Provider Demographics
NPI:1700065091
Name:AHMED, WAQAS (MD, FACP)
Entity Type:Individual
Prefix:
First Name:WAQAS
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11751 WYNNFIELD LAKES CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-4229
Mailing Address - Country:US
Mailing Address - Phone:904-544-3827
Mailing Address - Fax:866-339-2911
Practice Address - Street 1:10175 FORTUNE PKWY UNIT 302
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6749
Practice Address - Country:US
Practice Address - Phone:904-491-2160
Practice Address - Fax:904-389-5332
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115941207R00000X, 207RN0300X
OH35094102207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010258500Medicaid
FLHQ622ZMedicare PIN