DR. IMTIAZ RASUL (NPI# 1205071719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205071719 |
| Entity Type | Individual |
| Full Name | DR. IMTIAZ RASUL |
| Credential | M.D. |
| Practice Address |
10175 Fortune Pkwy Suite 104 Jacksonville FL 32256-6746 |
| Practice Telephone | 9043798748 |
| Practice Fax Number | 9043798796 |
| Mailing Telephone | 9043798748 |
| Mailing Fax Number | 9043798796 |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2014-11-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ME-112178 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
10175 FORTUNE PKWY SUITE 104 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-6746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730100587 | Mohammad Farooque | Psychiatry & Neurology | 10175 Fortune Pkwy, Suite #1106, Jacksonville, FL 32256-6746 | 2006-07-21 |
| 1902430614 | Delana Dampier | Technician | 10175 Fortune Pkwy, Jacksonville, FL 32256-6746 | 2020-03-03 |
| 1336780907 | Sunshine Medical Specialists, LLC | Pediatrics | 10175 Fortune Pkwy, Jacksonville, FL 32256-6746 | 2019-10-03 |
| 1376079905 | Ashley Raynor | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-05-02 |
| 1952834434 | Mollie Gibson | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-04-11 |
| 1720511728 | Desiree Adams | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-04-06 |
| 1538691555 | Meghan Rhegness | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-03-29 |
| 1568906048 | Alicia Miller | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-19 |
| 1417491036 | Mary Moore | Behavioral Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-16 |
| 1720522352 | Lavyn Taylor | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902441983 | Rebecca Taylor Dickerson | Psychiatry & Neurology | 5927 Old Timuquana Rd, Jacksonville, FL 32210-7889 | 2019-11-13 |
| 1821631045 | Rashan Jammeelah Jones | Psychiatry & Neurology | 5991 Chester Ave Ste 106, Jacksonville, FL 32217-2265 | 2019-10-21 |
| 1407320690 | Artistic Psychiatric Associates LLC | Psychiatry & Neurology | 9550 Regency Square Blvd Ste 903, Jacksonville, FL 32225-8116 | 2019-01-22 |
| 1447754080 | Julia Teytelbaum | Psychiatry & Neurology | 580 W 8th St Fl II6, Jacksonville, FL 32209-6533 | 2018-03-20 |
| 1205330933 | Luka Sogorovic | Psychiatry & Neurology | 580 W 8th St Fl 6, Jacksonville, FL 32209-6533 | 2018-03-19 |
| 1740636307 | Jonathan David Browning | Psychiatry & Neurology | 4884 Deer Creek Drive W, Jacksonville, FL 32246 | 2016-05-12 |
| 1033503503 | Victor Bryant Adriano Santos | Psychiatry & Neurology | 8823 San Jose Blvd Ste 301, Jacksonville, FL 32217-4290 | 2015-03-23 |
| 1336540830 | Angeles Alvarez-mullin | Psychiatry & Neurology | 7825 Baymeadows Way Suite 300, Florida Dept of Health, Division of Disabilities Determ, Jacksonville, FL 32256 | 2014-09-16 |
| 1639512833 | Robert D. Puder | Psychiatry & Neurology | 1250 Western Blvd Ste L2, #292, Jacksonville, NC 28546-6755 | 2013-04-08 |
| 1043586746 | Henry Lepely Md Pa | Psychiatry & Neurology | 4131 University Blvd S Ste 7, Jacksonville, FL 32216-4346 | 2012-03-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.