Healthcare Provider Details

I. General information

NPI: 1649525734
Provider Name (Legal Business Name): AYESHA AHMED M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 HAGEN RANCH RD STE 760
BOYNTON BEACH FL
33437-3777
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 561-733-4000
  • Fax: 561-733-5004
Mailing address:
  • Phone: 561-733-4400
  • Fax: 561-733-5004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME139705
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: