Provider Demographics
NPI:1750431300
Name:MOHAMMED H BAWANY MD P A
Entity type:Organization
Organization Name:MOHAMMED H BAWANY MD P A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAWANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-658-1719
Mailing Address - Street 1:716 S GOLDENROD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8108
Mailing Address - Country:US
Mailing Address - Phone:407-658-1719
Mailing Address - Fax:407-658-2536
Practice Address - Street 1:716 S GOLDENROD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8108
Practice Address - Country:US
Practice Address - Phone:407-658-1719
Practice Address - Fax:407-658-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053300261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259027100Medicaid
FL51790BMedicare ID - Type Unspecified
FL259027100Medicaid