MEDICARE: MAHMOUD OSMAN

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	347E00000X	Transportation Broker	413879	FL

General Provider Information

NPI Number	:	1215783824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHMOUD OSMAN

Provider Business Mailing Address
First Line	:	103 CENTURY 21 DR STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-9256
Country	:	US
Telephone Number	:	904-646-8698
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 CENTURY 21 DR STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-9256
Country	:	US
Telephone Number	:	904-646-8698
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2024
Last Update Date	:	04/25/2024

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Directions to “ MAHMOUD OSMAN ” Practice Location

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