Provider Demographics
NPI:1114011939
Name:ZAHRA, MOHAMMED KHALED (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:KHALED
Last Name:ZAHRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 W NASSAU ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-3814
Mailing Address - Country:US
Mailing Address - Phone:813-356-0196
Mailing Address - Fax:813-356-0197
Practice Address - Street 1:601 S ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4123
Practice Address - Country:US
Practice Address - Phone:813-353-8803
Practice Address - Fax:813-353-8602
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE175612085R0001X
FLME647132085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47077065413Medicaid
NEP00096003OtherRAILROAD MEDICARE
NEP00096003OtherRAILROAD MEDICARE
E20896Medicare UPIN