MEDICARE: FUTURE PEDIATRICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME92242	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144468224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUTURE PEDIATRICS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1430
Second Line	:
City	:	LYNN HAVEN
State	:	FL
Zip	:	32444-6230
Country	:	US
Telephone Number	:	850-767-4777
Fax Number	:	850-763-4988

Provider Business Practice Location Address
First Line	:	292 FOREST PARK CIR
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4921
Country	:	US
Telephone Number	:	850-767-4777
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AHMED ABOBAKER MOHAMED
Credential	:	M.D.
Telephone Number	:	850-767-4777

Provider Enumeration Date	:	01/28/2009
Last Update Date	:	08/31/2015

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Directions to “FUTURE PEDIATRICS, LLC ” Practice Location

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