Individual
DR. AHMED TAHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6050 BABCOCK ST SE STE 2, PALM BAY, FL 32909-4203
(321) 725-9946
Mailing address
2117 DEERCROFT DR, MELBOURNE, FL 32940-6349
(321) 355-0482
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21380
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111814100
—
FL
Enumeration date
06/29/2015
Last updated
04/16/2024
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