# DR EJAZ AHMED MD PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** URGENT CARE & FAMILY PRACTICE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245636042
- **Authorized official:** DR. EJAZ AHMED MD (PRESIDENT)
- **Authorized official phone:** (386) 235-8731

## Contact information

- **Practice address:** 405 NORTH CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2730
- **Practice address phone:** (386) 235-8731
- **Practice address fax:** (386) 269-9555
- **Mailing address:** 3848 CALLIOPE AVE, PORT ORANGE, FL 32129-6025
- **Mailing address phone:** (386) 235-8731
- **Mailing address fax:** (386) 269-9555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME95557 | FL | Yes |

## Other

- **Enumeration date:** 11/06/2014
- **Last updated:** 11/06/2014