Provider Demographics
NPI:1194761916
Name:AMAWI, AHMAD (MD)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:AMAWI
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 180898
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32718-0898
Mailing Address - Country:US
Mailing Address - Phone:407-331-4115
Mailing Address - Fax:407-331-4215
Practice Address - Street 1:5745 CANTON CV STE 121
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5012
Practice Address - Country:US
Practice Address - Phone:407-647-2550
Practice Address - Fax:407-647-0616
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92346208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2721473 00Medicaid
FL01591OtherBLUE CROSS
FL2721473 00Medicaid
FLI26799Medicare UPIN