Healthcare Provider Details

I. General information

NPI: 1710861711
Provider Name (Legal Business Name): AHMAD BARBOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AHMAD BARBUOR

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 SUN N LAKE BLVD FL 33872
SEBRING FL
33872-1986
US

IV. Provider business mailing address

4904 GRANADA BLVD
SEBRING FL
33872-2324
US

V. Phone/Fax

Practice location:
  • Phone: 863-449-9933
  • Fax:
Mailing address:
  • Phone: 863-449-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number43955
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: