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General NPI Number Information
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NPI Number | 1427005099
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Entity Type | Organization
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Legal Business Name | AHAD MAHOOTCHI, MD, PA
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 6739 GALL BLVD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-2522
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Country | US
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Telephone | 813-779-3338
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Fax | 813-779-3318
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Provider Business Mailing Address
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Address Line | PO BOX 1059
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City | ZEPHYRHILLS
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State | FL
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Zip | 33539-1059
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Country | US
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Telephone | 813-779-3338
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Fax | 813-779-3318
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Authorized Official
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Title or Position | PRESIDENT
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Name | AHAD MAHOOTCHI
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Credential | MD
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Telephone | 813-779-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | FL
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