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General NPI Number Information
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NPI Number | 1386721579
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Entity Type | Individual
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Provider Name | MOHAMED G MOHAMED MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 1914 STATE ROAD 44
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-8345
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Country | US
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Telephone | 386-428-3241
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Fax | 844-295-1379
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 200
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City | MIAMI
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State | FL
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Zip | 33126-3168
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Country | US
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Telephone | 305-500-2000
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Fax |
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | ME116369
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 252170
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD430130
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License Number State | PA
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