DR. ABDALLAH MOHAMED JEROUDI (NPI# 1730479650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730479650 |
Entity Type | Individual |
Full Name | DR. ABDALLAH MOHAMED JEROUDI |
Credential | MD |
Practice Address |
2639 Oak St Jacksonville FL 32204 |
Mailing Address |
8786 Perimeter Park Blvd Jacksonville FL 32216-6347 |
Practice Telephone | 9043875600 |
Practice Fax Number | 9043880114 |
Mailing Telephone | 9049979202 |
Mailing Fax Number | 9049961446 |
Enumeration Date | 2011-04-12 |
Last Update Date | 2019-06-11 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207W00000X | Ophthalmology | 77496 | GA | Allopathic & Osteopathic Physicians |
N | 207W00000X | Ophthalmology | ME130764 | FL | Allopathic & Osteopathic Physicians |
N | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
77496 | GA | Allopathic & Osteopathic Physicians |
Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
ME130764 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 0197472700 | 05 | |
GA | 003188625 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
8786 Perimeter Park Blvd, Jacksonville, FL 322166347 | 9049979202 | 9049961446 |
Street Address |
2639 OAK ST |
City | JACKSONVILLE |
State | FL |
Zip Code | 32204 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
Find all providers in zip 32204 |
Taxonomy Code | 207WX0107X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
Specialization | Retina Specialist |
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598253791 | Miami Eye & Retina, Inc | Ophthalmology | 4305 N Jefferson Ave, Miami Beach, FL 33140-2933 | 2018-04-24 |
1831608496 | Comprehensive Retina Consultants Pllc | Ophthalmology | 1501 N Us Highway 441 Ste 1106, The Villages, FL 32159-6800 | 2017-09-27 |
1538441811 | Pautler Cohen Findlay and Eichenbaum Mds Pa | Ophthalmology | 12903 N 56th St, Temple Terrace, FL 33617-1225 | 2011-09-13 |
1497076335 | Elizabeth R Richter | Ophthalmology | 3920 Bee Ridge Rd Bldg D, Sarasota, FL 34233-1207 | 2010-06-15 |
1013234624 | Christopher Roy Stelton | Ophthalmology | 3400 S Tamiami Trl Ste 101, Sarasota, FL 34239 | 2010-04-23 |
1457389447 | Mandeep Singh Dhalla | Ophthalmology | 6333 N Federal Hwy Ste 300, Fort Lauderdale, FL 33308 | 2006-06-29 |
1336144575 | Karina Billiris Findlay | Ophthalmology | 2705 W Saint Isabel St, Tampa, FL 33607-6319 | 2005-06-15 |
1659998482 | Don Hershelson Noel | Ophthalmology | 900 Nw 17th St, Miami, FL 33136-1119 | 2020-06-27 |
1457918625 | Gary Shienbaum Md Pa | Ophthalmology | 7261 Sheridan St Ste 100b, Hollywood, FL 33024-2708 | 2019-05-23 |
1235625039 | South Florida Retina Institute, Pllc | Ophthalmology | 20900 Ne 30th Ave Ste 207, Aventura, FL 33180 | 2018-07-03 |
Find all providers with the same taxonomy |
City | JACKSONVILLE |
Zip Code | 32204 |
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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.