=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346361169
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALMOIS ALI MOHAMAD MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2007
-----------------------------------------------------
Last Update Date | 05/31/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 SOUTHERN OAKS DR
-----------------------------------------------------
City | PLANT CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33563-1451
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-704-4218
-----------------------------------------------------
Fax | 866-658-2713
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2239
-----------------------------------------------------
City | ZEPHYRHILLS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33539-2239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-780-6687
-----------------------------------------------------
Fax | 866-658-2713
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 22650
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------