MEDICARE: DR. AHMAD ALSARAH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	158651	MI
2	208M00000X	Hospitalist Physician	ME158651	FL
3	207R00000X	Internal Medicine Physician	158651	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134644941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMAD ALSARAH MD

Provider Business Mailing Address
First Line	:	555 KENSINGTON LAKE CIR
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-3886
Country	:	US
Telephone Number	:	517-897-0172
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 BELL SHOALS RD STE 102
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8813
Country	:	US
Telephone Number	:	813-315-9435
Fax Number	:	813-409-3847

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2017
Last Update Date	:	06/18/2025

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