Healthcare Provider Details

I. General information

NPI: 1184838187
Provider Name (Legal Business Name): AHMED ELSAYED REZK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AHMED E REZK MD

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 MARTIN LUTHER KING JR BLVD
PANAMA CITY FL
32405-4414
US

IV. Provider business mailing address

PO BOX 578
PANAMA CITY FL
32402-0578
US

V. Phone/Fax

Practice location:
  • Phone: 850-257-5524
  • Fax: 850-257-5638
Mailing address:
  • Phone: 850-257-5524
  • Fax: 850-257-5638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME105520
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME105520
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: