MEDICARE: ANIS A. AHMADI 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	207RG0100X	Gastroenterology Physician	ME102708	FL
2	207R00000X	Internal Medicine Physician	ME102708	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	:	1932270832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIS A. AHMADI MD

Provider Business Mailing Address
First Line	:	216 SOUTHPARK CIR E
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-5135
Country	:	US
Telephone Number	:	904-824-6108
Fax Number	:	904-823-9613

Provider Business Practice Location Address
First Line	:	216 SOUTHPARK CIR E
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-5135
Country	:	US
Telephone Number	:	904-824-6108
Fax Number	:	904-823-9613

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	06/15/2011

Similar Medicare Providers

1093884793 — MR. JOHN R JONES JR.
Practice Location Address:

228 SOUTHPARK CIR E
SAINT AUGUSTINE, FL
32086-5135

Practice Phone: 904-797-5680
Practice Fax: 904-797-5681

1518146018 — MS. LISA M NESBITT C.R.N.A.
Practice Location Address:

216 SOUTHPARK CIR E
SAINT AUGUSTINE, FL
32086-5135

Practice Phone: 904-824-6108
Practice Fax: 904-823-9613

1780214767 — CHASTITY HALTAM APRN
Practice Location Address:

224 SOUTHPARK CIR E
SAINT AUGUSTINE, FL
32086-5135

Practice Phone: 904-342-4941
Practice Fax:

1669161113 — SAMANTHA LEE CROFT
Practice Location Address:

224 SOUTHPARK CIR E
SAINT AUGUSTINE, FL
32086-5135

Practice Phone: 904-342-4941
Practice Fax:

1801291398 — MS. DEANGELA EDWARDS LPN
Practice Location Address:

2638 SAN RAFAEL PL
SAINT LOUIS, MO
63114-5135

Practice Phone: 314-265-1221
Practice Fax:

1114539137 — BROOKE MARISSA TUBBS
Practice Location Address:

5135 REDSTONE RD
SAINT LOUIS, MI
48880-9602

Practice Phone: 989-513-9360
Practice Fax:

Directions to “ ANIS A. AHMADI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.