Individual provider Active NPI

Mohammad Afzal, MD MBA

  • Pediatrics Physician
  • Clermont, FL
National Provider Identifier
1669411161
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 72542 Issued in FL
Practice address
265 Citrus Tower Blvd
Ste 102
Clermont, FL 34711-1908
Phone
(352) 394-3929
Fax
(352) 394-6446
NPI assigned
Jun 6, 2006
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 72542 FL Primary
Pediatrics Physician 208000000X 3193271205 UT

Addresses

Primary practice location

265 Citrus Tower Blvd
Ste 102
Clermont, FL 34711-1908

Mailing address

265 Citrus Tower Blvd
Ste 102
Clermont, FL 34711-1908
Phone (352) 394-3929

Other identifiers 2

IdentifierTypeStateIssuer
260332200MedicaidFL
593711113OtherFLTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100408000408 FL Practitioner - Pediatric Medicine 3779536701 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 72542FLMDPediatrics Physician
3193271205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Pediatrics CurrentSince May 1, 2011 Accepting new patients
Excel Pediatrics PA Pediatrics CurrentSince May 1, 2001 Accepting new patients
Leesburg Pediatrics PA Pediatrics PastSince May 6, 2013 Accepting new patients
Sumter Pediatrics PA Pediatrics PastSince Sep 1, 2014 Accepting new patients
Excel Pediatrics Past Accepting new patients
Sumter Pediatrics PA PastSince Jul 25, 2021 Accepting new patients
Excel Pediatrics Pediatrics Past Accepting new patients
Tavares Pediatrics Inc PastSince Sep 1, 2011 Accepting new patients
Excel Pediatrics PA Past Accepting new patients
Excel Pediatrics and Family Care Past Accepting new patients
Professional Pediatrics PastSince Jul 25, 2021 Accepting new patients

Locations

1050 US Highway 27
Ste 5
Clermont, FL 34714
Phone (352) 404-8944

265 Citrus Tower Blvd
Clermont, FL 34711
Phone (352) 394-3929

265 Citrus Tower Blvd
Ste 102
Clermont, FL 34711
Phone (352) 394-3929

711 S Highway 27
Ste E
Clermont, FL 34711
Phone (352) 243-9333

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15724/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Excel PediatricsClermont, FL, CCN 108981 Rural health clinic 5% Or Greater Direct Ownership Interest
Corporate Director
W-2 Managing Employee
May 1, 2001
Mar 2, 2005
May 1, 2001
Tavares Pediatrics IncTavares, FL, CCN 103928 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
W-2 Managing Employee
Sep 1, 2011
Sep 1, 2011
Sep 1, 2011
Professional PediatricsClermont, FL, CCN 103924 Rural health clinic 5% Or Greater Direct Ownership Interest Sep 1, 2011
Leesburg Pediatrics PALeesburg, FL, CCN 683841 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Director (100%)
W-2 Managing Employee
May 6, 2013
May 6, 2013
May 6, 2013
Sumter Pediatrics PASumterville, FL, CCN 683816 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
W-2 Managing Employee
Sep 1, 2014
Sep 1, 2014
Sep 1, 2014

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1669411161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 CITRUS TOWER BLVD",
            "address_2": "STE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111908",
            "telephone_number": "352-394-3929",
            "fax_number": "352-394-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 CITRUS TOWER BLVD",
            "address_2": "STE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111908",
            "telephone_number": "352-394-3929",
            "fax_number": "352-394-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFZAL",
        "first_name": "MOHAMMAD",
        "credential": "MD MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 72542",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "3193271205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260332200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "593711113",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.