MEDICARE: NOUSHAD MAMUN DO

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	OS22946	FL

General Provider Information

NPI Number	:	1134757362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOUSHAD MAMUN DO

Provider Business Mailing Address
First Line	:	13564 VILLAGE PARK DR UNIT 150
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-7765
Country	:	US
Telephone Number	:	321-843-5851
Fax Number	:	407-599-1691

Provider Business Practice Location Address
First Line	:	13564 VILLAGE PARK DR UNIT 150
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-7765
Country	:	US
Telephone Number	:	321-843-5851
Fax Number	:	407-599-1691

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

Provider Enumeration Date	:	04/01/2020
Last Update Date	:	10/30/2025

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Directions to “ NOUSHAD MAMUN DO” Practice Location

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