Provider Demographics
NPI:1558857771
Name:AHMED, UMAR TALAL (OD)
Entity type:Individual
Prefix:DR
First Name:UMAR
Middle Name:TALAL
Last Name:AHMED
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6718 LAKE NONA BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7984
Mailing Address - Country:US
Mailing Address - Phone:407-857-3937
Mailing Address - Fax:407-392-0420
Practice Address - Street 1:6718 LAKE NONA BLVD STE 140
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7984
Practice Address - Country:US
Practice Address - Phone:407-857-3937
Practice Address - Fax:407-392-0420
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5599152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist