Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME0068923 | FL |
Y | 111NI0900X | Internist | ME0068923 | FL |
N | 207RG0300X | Geriatric Medicine | ME0068923 | FL |
NPI | 1013942366 |
---|---|
Provider Name | Syed Waseemuddin Ahmed Md |
First Address | Winter Haven, FL 33883-7309 |
Second Address | Winter Haven, FL 33880-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 18/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250248800 | (05) | FL |
593688407 | AETNA,BCBS,CIGNA (01) | FL |
G25389 | (02) | FL |