Healthcare Provider Details

I. General information

NPI: 1649188574
Provider Name (Legal Business Name): IBRAHIMAHMED, D.O., PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E SAMPLE RD
DEERFIELD BEACH FL
33064-3502
US

IV. Provider business mailing address

6463 COLOMERA DR
BOCA RATON FL
33433-8242
US

V. Phone/Fax

Practice location:
  • Phone: 850-381-1852
  • Fax:
Mailing address:
  • Phone: 850-381-1852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED IBRAHIM AHMED
Title or Position: OWNER
Credential: MD
Phone: 850-381-1852