Provider Demographics
NPI:1023248911
Name:MAHDY, AYMAN
Entity type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:
Last Name:MAHDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636256 CENTRAL CREDENTIALING
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-585-5506
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:218 STRATHY LN
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4133
Practice Address - Country:US
Practice Address - Phone:407-628-3073
Practice Address - Fax:407-628-3078
Is Sole Proprietor?:No
Enumeration Date:2009-07-26
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162510208800000X
FLHSE10865208800000X
ARE06271208800000X
OH35.096476208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3120438Medicaid
IN201014150Medicaid
KY7100150490Medicaid
AR5AA10Medicare PIN
KY7100150490Medicaid