MEDICARE: RAYYAN NEUROLOGICAL ASSOCIATION LLC

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	2084N0400X	Neurology Physician

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	:	1164995528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAYYAN NEUROLOGICAL ASSOCIATION LLC

Provider Business Mailing Address
First Line	:	10022 CRYSTALLINE CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-6024
Country	:	US
Telephone Number	:	646-431-6976
Fax Number	:

Provider Business Practice Location Address
First Line	:	10022 CRYSTALLINE CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-6024
Country	:	US
Telephone Number	:	646-431-6976
Fax Number	:

Authorized Official
Title or Position	:	NEUROLOGIST
Name	:	DR. SHAFIUDDIN AHMED
Credential	:	MD
Telephone Number	:	646-431-6976

Provider Enumeration Date	:	01/09/2019
Last Update Date	:	01/14/2019

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