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General NPI Number Information
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NPI Number | 1104802305
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Entity Type | Individual
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Provider Name | ASHIK NISAR AHMAD MD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1210 S OLD DIXIE HWY
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City | JUPITER
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State | FL
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Zip | 33458-7205
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Country | US
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Telephone | 239-343-6260
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Fax | 239-343-6259
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Provider Business Mailing Address
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Address Line | 1210 S OLD DIXIE HWY
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City | JUPITER
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State | FL
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Zip | 33458-7205
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Country | US
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Telephone | 561-263-4460
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Fax | 239-343-6259
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME93391
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | ME93391
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | ME93391
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License Number State | FL
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