Individual
AHMED F EBRAHEEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1.063933
CT
207R00000X
Internal Medicine Physician
35.133234
OH
207R00000X
Internal Medicine Physician
Primary
ME166073
FL
208M00000X
Hospitalist Physician
1.063933
CT
208M00000X
Hospitalist Physician
ME166073
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121671600
—
FL
01
—
SO885
MEDICARE HF
FL
Enumeration date
06/16/2015
Last updated
01/15/2025
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