Healthcare Provider Details

I. General information

NPI: 1184614992
Provider Name (Legal Business Name): MOHAMMED WAHEED KAASHMIRI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 S JOHN YOUNG PKWY
ORLANDO FL
32839-3716
US

IV. Provider business mailing address

11744 VINCI DR
WINDERMERE FL
34786-5684
US

V. Phone/Fax

Practice location:
  • Phone: 497-434-8171
  • Fax: 407-506-0003
Mailing address:
  • Phone: 315-269-6393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number202564-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME118440
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: