Healthcare Provider Details

I. General information

NPI: 1023571601
Provider Name (Legal Business Name): AHMAD SAEED IMAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10155 DOWDEN RD STE 200
ORLANDO FL
32832-5224
US

IV. Provider business mailing address

10155 DOWDEN RD STE 200
ORLANDO FL
32832-5224
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA195251
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: