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NPI Code Detail

MEDICARE: MRS. ASTRA MOHAMMED PA-C

MEDICARE: MRS. ASTRA MOHAMMED PA-C
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
1363AS0400XSurgical Physician AssistantNY
2363A00000XPhysician AssistantPA9110245FL

Other Identifiers

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

General Provider Information

NPI Number : 1366607681
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASTRA MOHAMMED PA-C
Provider Business Mailing Address
First Line : 1812 N MILLS AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32803-1834
Country : US
Telephone Number : 407-897-3499
Fax Number : 407-896-9454
Provider Business Practice Location Address
First Line : 1812 N MILLS AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32803-1834
Country : US
Telephone Number : 407-897-3499
Fax Number : 407-896-9454
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2008
Last Update Date : 12/19/2018

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Directions to “ MRS. ASTRA MOHAMMED PA-C” Practice Location

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