Ilyas, Mohammad

Ilyas, Mohammad is an individual health care provider with primary practice located at 820 Prudential Dr Ste 405 Ufjp Pediatric Multispecialty, Jacksonville FL 32207-8206. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Nephrology. Allopathic & Osteopathic Physicians / Pediatric Nephrology is his primary health care specialty. Ilyas, Mohammad can be contacted via phone (904) 633-0920.

Contact Information

Primary practice address
820 Prudential Dr Ste 405 Ufjp Pediatric Multispecialty Jacksonville FL 32207-8206
Phone: (904) 633-0920
Fax: (904) 600-0921
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME75454 Florida
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X ME75454 Florida

Profile Details

NPI number 1104895416
LBN Legal business name Ilyas, Mohammad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Apr 1st, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104895416 NPPES
Georgia MEDICAID 000923898A
Georgia MEDICAID 2593840-00
Georgia Other 370020436

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