Jeroudi, Abdallah Mohamed

Jeroudi, Abdallah Mohamed is an individual health care provider with primary practice located at 2639 Oak St , Jacksonville FL 32204-4505. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Jeroudi, Abdallah Mohamed can be contacted via phone (904) 387-5600.

Contact Information

Primary practice address
2639 Oak St Jacksonville FL 32204-4505
Phone: (904) 387-5600
Fax: (904) 388-0114
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 77496 Georgia
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 77496 Georgia
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X ME130764 Florida
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME130764 Florida

Profile Details

NPI number 1730479650
LBN Legal business name Jeroudi, Abdallah Mohamed
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2011
Last updated Apr 20th, 2023 - about 2 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 1730479650 NPPES
Georgia MEDICAID 003188625
Georgia MEDICAID 019742700

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