Healthcare Provider Details

I. General information

NPI: 1477501237
Provider Name (Legal Business Name): MEHMOOD NAWAB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14605 ISLEVIEW DR
WINTER GARDEN FL
34787-6203
US

IV. Provider business mailing address

3050 DYER BLVD STE 139
KISSIMMEE FL
34741-7839
US

V. Phone/Fax

Practice location:
  • Phone: 321-481-6490
  • Fax:
Mailing address:
  • Phone: 321-481-6490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number34755
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number34755
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME89905
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: