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General NPI Number Information
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NPI Number | 1396703195
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Entity Type | Organization
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Legal Business Name | MAHMOUD A NIMER MD PA
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 14540 CORTEZ BLVD SUITE # 113
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6056
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Country | US
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Telephone | 352-596-4022
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Fax | 352-596-9851
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Provider Business Mailing Address
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Address Line | 14540 CORTEZ BLVD SUITE # 113
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6056
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Country | US
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Telephone | 352-596-4022
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Fax | 352-596-9851
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | DR. MAHMOUD A NIMER
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Credential | M.D.
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Telephone | 352-596-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME0066235
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License Number State | FL
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