Provider Demographics
NPI:1154387165
Name:MAHMOOD, JAFAR (MD)
Entity type:Individual
Prefix:
First Name:JAFAR
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7319 STONEROCK CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8002
Mailing Address - Country:US
Mailing Address - Phone:407-352-5323
Mailing Address - Fax:407-352-6233
Practice Address - Street 1:807 S ORLANDO AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4870
Practice Address - Country:US
Practice Address - Phone:407-894-4693
Practice Address - Fax:407-261-3869
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2014-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME79931207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259893100Medicaid
FL134629173OtherGROUP NPI
FL259893100Medicaid
FL134629173OtherGROUP NPI
FLG23705Medicare UPIN