Individual
ABDUL QUYYUM AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2605 W LAKE MARY BLVD, SUITE 119, LAKE MARY, FL 32746-3568
(407) 878-7990
Mailing address
2605 W LAKE MARY BLVD, SUITE 119, LAKE MARY, FL 32746-3568
(407) 878-7990
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
44333
KY
207Q00000X
Family Medicine Physician
Primary
ME121657
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100124970
—
KY
01
—
IM742Z
MEDICARE PTAN
FL
Enumeration date
06/19/2009
Last updated
09/05/2024
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