Healthcare Provider Details

I. General information

NPI: 1952357840
Provider Name (Legal Business Name): SALMAN AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOOTH RD SUITE A
ORMOND BEACH FL
32174-5716
US

IV. Provider business mailing address

303 N CLYDE MORRIS BLVD
DAYTONA BEACH FL
32114-2709
US

V. Phone/Fax

Practice location:
  • Phone: 386-523-1212
  • Fax: 386-523-1213
Mailing address:
  • Phone: 386-425-3627
  • Fax: 386-226-4577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberME0071551
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0071551
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: