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Individual

AHMAD SHOKOOHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7480 ALOMA AVE, WINTER PARK, FL 32792-9102
(407) 657-7799
(407) 657-7928
Mailing address
7480 ALOMA AVE, WINTER PARK, FL 32792-9102
(407) 657-7799
(407) 657-7928

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33049
FL
207V00000X
Obstetrics & Gynecology Physician
33049
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
037761900
FL
01
33049
STATE
FL
01
FS0901339
CHAMPUS TRICARE
Enumeration date
07/14/2006
Last updated
09/14/2010
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