Individual
IMTIAZ AHMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16420 HEALTHPARK COMMONS DR, SUITE 100, FORT MYERS, FL 33908-9621
(239) 437-6670
(239) 437-8871
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
V0672
TX
207RP1001X
Pulmonary Disease Physician
Primary
ME76783
FL
207RP1001X
Pulmonary Disease Physician
V0672
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
ME76783
FL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
V0672
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2066082
CIGNA
FL
01
—
264114
WELLCARE THROUGH LEE PHO
FL
05
—
2705354-00
—
FL
01
—
307272
AVMED
FL
01
—
42972
BCBS OF FL
FL
01
—
7809584
AETNA
FL
01
—
ASLC2013
FREEDOM HEALTH
FL
01
—
P01266913
RAILROAD MCR
FL
01
—
P930339
OPTIMUM
FL
Enumeration date
07/13/2005
Last updated
05/15/2024
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