Healthcare Provider Details

I. General information

NPI: 1265608038
Provider Name (Legal Business Name): NEVINE MAHMOUD MD, MS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7991 BEECHMONT AVE
CINCINNATI OH
45255-3189
US

IV. Provider business mailing address

2100 SE OCEAN BLVD STE 202
STUART FL
34996-3332
US

V. Phone/Fax

Practice location:
  • Phone: 513-346-3399
  • Fax:
Mailing address:
  • Phone: 772-252-5265
  • Fax: 772-874-3115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101256472
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number065557
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number065557
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME120943
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number35125100
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.159561
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: