Provider Demographics
NPI:1912998436
Name:FAHMY, AMIR A (MD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:A
Last Name:FAHMY
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 1:3345 BURNS RD
Mailing Address - Street 2:STE#204
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4324
Mailing Address - Country:US
Mailing Address - Phone:561-622-7604
Mailing Address - Fax:561-622-7542
Practice Address - Street 1:3345 BURNS RD STE 204
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4306
Practice Address - Country:US
Practice Address - Phone:561-622-7604
Practice Address - Fax:561-622-7542
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0076114207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG85607Medicare UPIN
FLE1911WMedicare PIN