Fahdi, Ibrahim

Fahdi, Ibrahim is an individual health care provider with primary practice located at 1681 Eagle Harbor Pkwy Ste 101 , Fleming Island FL 32003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Fahdi, Ibrahim can be contacted via phone (904) 644-0092.

Contact Information

Primary practice address
1681 Eagle Harbor Pkwy Ste 101 Fleming Island FL 32003
Phone: (904) 644-0092
Fax: (904) 644-0099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME113759 Florida

Profile Details

NPI number 1588754055
LBN Legal business name Fahdi, Ibrahim
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Jul 12th, 2018 - about 8 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 1588754055 NPPES
Florida MEDICAID 006622500
Florida Other P00165055
Florida MEDICAID 1588754055

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