Healthcare Provider Details
I. General information
NPI: 1497637300
Provider Name (Legal Business Name): AHMED MOHAMED
Entity Type: Individual
Gender:
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/22/2025
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13601 BRUCE B DOWNS BLVD STE 300
TAMPA FL
33613-4653
US
IV. Provider business mailing address
13601 BRUCE B DOWNS BLVD STE 300
TAMPA FL
33613-4653
US
V. Phone/Fax
- Phone: 813-615-8235
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: