Imtiaz Mohammed

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11007133 Issued in FL

Practice address

9655 Boynton Beach Blvd
Boynton Beach, FL 33472-4421

Phone

(561) 336-7001

NPI assigned

May 15, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, FL2 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589587200000",
    "number": "1982226684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9655 BOYNTON BEACH BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334724421",
            "telephone_number": "561-336-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 BOYNTON BEACH BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334724421",
            "telephone_number": "561-336-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "IMTIAZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-16",
        "certification_date": "2020-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11007133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobile Woundcare Partners LLC
• Mobilemed Florida LLC
• Modern Dental Smiles PA
• Modern Reality
• Haasseem Mohammed, D.C
• Saudia Mohammed, MS
• Jodie Camille Moise, FNP-BC
• Brenna Dyan Molinary
• Ricard Moncion, APRN
• Himler Mondesir, PHARM.D

• Family Nurse Practitioner in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.