MEDICARE: DR. AHMED M ELKEEB 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
1	207W00000X	Ophthalmology Physician	ME172681	FL
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	2016018569	MO
3	207W00000X	Ophthalmology Physician	2016018569	MO
4	207WX0107X	Retina Specialist (Ophthalmology) Physician	ME172681	FL

General Provider Information

NPI Number	:	1568648699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMED M ELKEEB M.D.

Provider Business Mailing Address
First Line	:	3627 UNIVERSITY BLVD S STE 605
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-7401
Country	:	US
Telephone Number	:	904-658-0176
Fax Number	:	904-605-4872

Provider Business Practice Location Address
First Line	:	3627 UNIVERSITY BLVD S STE 605
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-7401
Country	:	US
Telephone Number	:	904-658-0176
Fax Number	:	904-605-4872

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

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	12/15/2025

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