Individual
EJAZ AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
405 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2730
(386) 506-8555
(386) 944-9944
Mailing address
405 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2730
(386) 506-8555
(386) 944-9944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME95557
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020641400
—
FL
Enumeration date
07/11/2006
Last updated
04/22/2021
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