Provider Demographics
NPI:1194701193
Name:AHMED, NASIM (MD)
Entity type:Individual
Prefix:DR
First Name:NASIM
Middle Name:
Last Name:AHMED
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:PO BOX 690818
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-0818
Mailing Address - Country:US
Mailing Address - Phone:407-292-1414
Mailing Address - Fax:407-290-1765
Practice Address - Street 1:7328 STONEROCK CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8000
Practice Address - Country:US
Practice Address - Phone:407-292-1414
Practice Address - Fax:407-290-1765
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81302207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261531200Medicaid
FLE6987ZMedicare PIN
FLD49553Medicare UPIN
FL261531200Medicaid