Basic Information
Provider Information
NPI: 1003299330
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABDEL RAHMAN
FirstName: ZAID
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4500 SAN PABLO RD S
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322241865
CountryCode: US
TelephoneNumber: 9049532000
FaxNumber:  
Practice Location
Address1: 4500 SAN PABLO RD S
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 32224
CountryCode: US
TelephoneNumber: 9049532000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/06/2015
LastUpdateDate: 08/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301107926MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0003XME135338FLY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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