MEDICARE: DR. MOHAMMED A MERCHANT D.O.

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	207R00000X	Internal Medicine Physician	OS9267	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00196111	OTHER	FL	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	48168	OTHER	FL	BCBS
2	295230	OTHER	FL	AVMED
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639130230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMED A MERCHANT D.O.

Provider Business Mailing Address
First Line	:	5151 WINTER GARDEN VINELAND RD STE 208
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-6098
Country	:	US
Telephone Number	:	407-612-4007
Fax Number	:	407-612-4017

Provider Business Practice Location Address
First Line	:	5151 WINTER GARDEN VINELAND RD STE 208
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-6098
Country	:	US
Telephone Number	:	407-612-4007
Fax Number	:	407-612-4017

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	04/29/2024

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Directions to “ DR. MOHAMMED A MERCHANT D.O.” Practice Location

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