Healthcare Provider Details

I. General information

NPI: 1366330557
Provider Name (Legal Business Name): TAMMY MARIE AHMED HHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 W 22ND ST
JACKSONVILLE FL
32209-4309
US

IV. Provider business mailing address

1115 W 22ND ST
JACKSONVILLE FL
32209-4309
US

V. Phone/Fax

Practice location:
  • Phone: 207-319-2049
  • Fax:
Mailing address:
  • Phone: 207-319-2049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: