1487951737 NPI number — REDA ALAMI MD PA

Table of content: (NPI 1487951737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487951737 NPI number — REDA ALAMI MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REDA ALAMI MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487951737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3123
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST AUGUSTINE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32085-3123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-824-4990
Provider Business Mailing Address Fax Number:
904-824-2226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 HEALTH PARK BLVD
Provider Second Line Business Practice Location Address:
STE 219
Provider Business Practice Location Address City Name:
ST AUGUSTINE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32086-5793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-814-8085
Provider Business Practice Location Address Fax Number:
904-460-2888
Provider Enumeration Date:
02/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
ALAMI
Authorized Official First Name:
REDA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
904-814-8085

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  ME102729 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 003290400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com