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NPI Code Detail

MEDICARE: MOHAMED A OMER M.D.

MEDICARE: MOHAMED A OMER M.D.
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
1207RI0011XInterventional Cardiology PhysicianME158589FL
2207RI0011XInterventional Cardiology Physician73295WI
3207RC0000XCardiovascular Disease Physician66394MN
4207RC0000XCardiovascular Disease PhysicianME158589FL
5207RC0000XCardiovascular Disease Physician73295WI

General Provider Information

NPI Number : 1366784670
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMED A OMER M.D.
Provider Business Mailing Address
First Line : 511 MEDICAL PLAZA DR STE 101
Second Line :
City : LEESBURG
State : FL
Zip : 34748-7328
Country : US
Telephone Number : 352-728-6808
Fax Number : 352-728-1743
Provider Business Practice Location Address
First Line : 511 MEDICAL PLAZA DR STE 101
Second Line :
City : LEESBURG
State : FL
Zip : 34748-7328
Country : US
Telephone Number : 352-728-6808
Fax Number : 352-728-1743
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2013
Last Update Date : 05/11/2026

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1265742332 — MS. MELINDA KIM DOYLE ARNP
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34748-7328
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Practice Fax:
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511 MEDICAL PLAZA DR STE 101
LEESBURG, FL
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1962848382 — ROBERT B GIBSON M.D.
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Directions to “ MOHAMED A OMER M.D.” Practice Location

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