Abdallah Mohamed Jeroudi (NPI# 1730479650, PAC ID# 7012228323) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1730479650 |
| PAC ID by PECOS | 7012228323 |
| Professional Enrollment ID | I20170615001851 |
| Full Name | Abdallah Mohamed Jeroudi |
| Organization Legal Name | FLORIDA RETINA INSTITUTE JAMES A STAMAN MD PA |
| Address |
304 Riverside Dr Waycross GA 31501-4549 |
| Phone Number | 9122831400 |
| Gender | M |
| Medical School | BAYLOR COLLEGE OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | OPHTHALMOLOGY |
| Group Practice PAC ID | 8123004702 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100040 | ST VINCENT'S MEDICAL CENTER RIVERSIDE |
| Address | Phone | Organization |
|---|---|---|
| 664 Scranton Rd, Suite 107, Brunswick, GA 31520-1946 | 9122629092 | FLORIDA RETINA INSTITUTE JAMES A STAMAN MD PA |
| 2639 Oak St, Jacksonville, FL 32204-4505 | 9043875600 | FLORIDA RETINA INSTITUTE JAMES A STAMAN MD PA |
| 8786 Perimeter Park Blvd, Jacksonville, FL 32216-6347 | 9049979202 | FLORIDA RETINA INSTITUTE JAMES A STAMAN MD PA |
| 304 Riverside Dr, Waycross, GA 31501-4549 | 9122831400 | FLORIDA RETINA INSTITUTE JAMES A STAMAN MD PA |
| Organization Legal Name | FLORIDA RETINA INSTITUTE JAMES A STAMAN MD PA |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tomas Alejandro Moreno | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 1100 Plantation Blvd, Suite 130, Saint Augustine, FL 32080 |
| Benjamin John Thomas | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 304 Riverside Dr, Waycross, GA 31501-4549 |
| Jonathan Alexander Staman | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 2639 Oak St, Jacksonville, FL 32204-4505 |
| Matthew Alexander Cunningham | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 1025 Primera Blvd, Lake Mary, FL 32746-2175 |
| William J Dunn | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 564 Health Blvd, Daytona Beach, FL 32114-1492 |
| Elias Mavrofrides | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 1025 Primera Blvd, Lake Mary, FL 32746-2175 |
| Thomas A Barnard | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 1025 Primera Blvd, Lake Mary, FL 32746-2175 |
| James A Staman | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 2639 Oak St, Jacksonville, FL 32204-4505 |
| Samuel K Houston IIi | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 1025 Primera Blvd, Lake Mary, FL 32746-2175 |
| Jaya B Kumar | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 1025 Primera Blvd, Lake Mary, FL 32746-2175 |
| Street Address |
304 RIVERSIDE DR |
| City | WAYCROSS |
| State | GA |
| Zip | 31501-4549 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin John Thomas | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 304 Riverside Dr, Waycross, GA 31501-4549 |
| Raul J Moreno | Ophthalmology | Florida Retina Institute James A Staman Md Pa | 304 Riverside Dr, Waycross, GA 31501-4549 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelly Gilbert | Chiropractic | 1705 Blvd Sq, Suite C, Waycross, GA 31501 | |
| Zachary Boeskool | Optometry | Myeyedr Optometry of Georgia, LLC | 2209 Memorial Dr, Waycross, GA 31501-0902 |
| William Perry Giles | Optometry | Myeyedr Optometry of Georgia, LLC | 2209 Memorial Dr, Waycross, GA 31501-0902 |
| Scott H Petermann | Ophthalmology | South Georgia Eye Partners PC | 1730 Brunswick Hwy, Waycross, GA 31501-0908 |
| Rodney Brown | Optometry | 1730 Brunswick Hwy, Waycross, GA 31501-0908 | |
| Jarrod Griffis | Optometry | American Eyecare Center Waycross PC | 1730 Brunswick Hwy, Waycross, GA 31501-0908 |
| Peggy S Achenbach | Optometry | Myeyedr Optometry of Georgia, LLC | 2215 Memorial Dr, Suite 25, Waycross, GA 31501-0987 |
| Brandon Hall | Nurse Practitioner | Applecare LLC | 1912 Memorial Dr, Suite E, Waycross, GA 31501-0989 |
| Amber C Pittman | Nurse Practitioner | Applecare LLC | 1912 Memorial Dr, Suite E, Waycross, GA 31501-0989 |
| Carmen Jackson | Nurse Practitioner | Applecare LLC | 1912 Memorial Dr, Suite E, Waycross, GA 31501-0989 |
| Find all physicians in zip 31501 | |||
| City | WAYCROSS |
| Zip Code | 31501 |
| Specialty | OPHTHALMOLOGY |
| City + Specialty | WAYCROSS + OPHTHALMOLOGY |
Please comment or provide details below to improve the information on Abdallah Mohamed Jeroudi.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.