Basic Information
| Provider Information | |||||||||
| NPI: | 1376830109 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHMED | ||||||||
| FirstName: | JUNAID | ||||||||
| MiddleName: | ABDUL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8773 PERIMETER PARK CT | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322161165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9044933390 | ||||||||
| FaxNumber: | 9044933395 | ||||||||
| Practice Location | |||||||||
| Address1: | 7807 BAYMEADOWS RD E | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322569664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043301024 | ||||||||
| FaxNumber: | 9043301027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2011 | ||||||||
| LastUpdateDate: | 10/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME 113367 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | S8950 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 336.083667 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | MD61068195 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 01084604A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 2021009894 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | ME113367 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 356965 | 01 | FL | AVMED | OTHER | 004XP | 01 | FL | FLORIDA BLUE - GROUP | OTHER | 0063488-00 | 05 | FL | MEDICAID | 0103467-00 | 01 | FL | FL MEDICAID - GROUP | OTHER | 2173912 | 05 | WA | MEDICAID | 9485883 | 01 | FL | AETNA | OTHER | HR822A | 01 | FL | FL MEDICARE - GROUP | OTHER | 4463627 | 01 | FL | CIGNA | OTHER | 003129995A | 01 | GA | GEORGIA MEDICAID | OTHER | DU5524 | 01 | FL | RR MEDICARE - GROUP | OTHER | 785407 | 01 | FL | WELLCARE | OTHER | 14M11 | 01 | FL | FLORIDA BLUE - INDIVIDUAL | OTHER | PO1153907 | 01 | FL | RR MEDICARE - INDIVIDUAL | OTHER |