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Individual

AHMED ELBANNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2884 WELLNESS AVE, STE 100, ORANGE CITY, FL 32763
(386) 668-2221
(386) 668-2228
Mailing address
2884 WELLNESS AVE, STE 100, ORANGE CITY, FL 32763
(386) 668-2221
(386) 668-2228

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101022515
MI
207RG0100X
Gastroenterology Physician
Primary
OS20018
FL

Other

Enumeration date
03/31/2016
Last updated
07/31/2023
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