Mohammad Idrees MD, P.a.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME22385 Issued in FL

Legal business name

MOHAMMAD IDREES MD, P.A.

Practice address

1454 Belaire Lane N.E.
Palm Bay, FL 32905

Phone

(321) 723-2121

Fax

(321) 723-7478

NPI assigned

May 23, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amber Lee Tedder

Title

Medical Assistant

Phone

(321) 723-2121

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1326308313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 BELAIRE LANE N.E.",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "32905",
            "telephone_number": "321-723-2121",
            "fax_number": "321-723-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 BELAIRE LANE N.E.",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "32905",
            "telephone_number": "321-723-2121",
            "fax_number": "321-723-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMMAD IDREES MD, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "TEDDER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MEDICAL ASSISTANT",
        "authorized_official_telephone_number": "321-723-2121"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME22385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "#054484100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Mithil
• Fanel Mitial
• Mobile Medical Equipment Repair, LLC (Space Coast Mobility)
• Devang N Modi, R.PH,MS
• Hiral Mukundkumar Modi, D.M.D
• Adrienne Michelle Monica, RBT
• Jeremy Delos Monk
• Jeffrey A Monteleon, D.C.
• Gene Montes, LDO
• Yasmin Montesino

• Gastroenterology Physician in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.