Healthcare Provider Details

I. General information

NPI: 1427340355
Provider Name (Legal Business Name): ASIM S AHMED DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 US HIGHWAY 98 W STE 110
MIRAMAR BEACH FL
32550
US

IV. Provider business mailing address

PO BOX 2699
PENSACOLA FL
32513-2699
US

V. Phone/Fax

Practice location:
  • Phone: 850-267-1603
  • Fax:
Mailing address:
  • Phone: 850-475-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberOS16024
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: