MEDICARE: WASIM AHMAR MD

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	207RI0011X	Interventional Cardiology Physician	ME78066	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

General Provider Information

NPI Number	:	1528061330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WASIM AHMAR MD

Provider Business Mailing Address
First Line	:	450 W STATE ROAD 434
Second Line	:	STE 301
City	:	LONGWOOD
State	:	FL
Zip	:	32750-5187
Country	:	US
Telephone Number	:	407-767-8200
Fax Number	:	407-339-1200

Provider Business Practice Location Address
First Line	:	450 W STATE ROAD 434
Second Line	:	STE 301
City	:	LONGWOOD
State	:	FL
Zip	:	32750-5187
Country	:	US
Telephone Number	:	407-767-8200
Fax Number	:	407-339-1200

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/09/2012

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Directions to “ WASIM AHMAR MD” Practice Location

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