Healthcare Provider Details

I. General information

NPI: 1518937010
Provider Name (Legal Business Name): SYED ABID MAHMOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 STATE AVE STE 303
PANAMA CITY FL
32405-4590
US

IV. Provider business mailing address

27200 LAHSER RD SUITE 100
SOUTHFIELD MI
48034-2137
US

V. Phone/Fax

Practice location:
  • Phone: 850-872-3939
  • Fax:
Mailing address:
  • Phone: 248-208-9216
  • Fax: 248-208-9217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME151000
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301064072
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME151000
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: