1043922164 NPI number — MR. ABDULAZIZ SALEH ALGHAMDI MD

Table of content: MR. ABDULAZIZ SALEH ALGHAMDI MD (NPI 1043922164)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043922164 NPI number — MR. ABDULAZIZ SALEH ALGHAMDI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALGHAMDI
Provider First Name:
ABDULAZIZ
Provider Middle Name:
SALEH
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1043922164
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UF HEALTH PROTON THERAPY INSTITUTE
Provider Second Line Business Mailing Address:
2015 NORTH JEFFERSON STREET
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-588-1480
Provider Business Mailing Address Fax Number:
904-588-1300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UF HEALTH PROTON THERAPY INSTITUTE
Provider Second Line Business Practice Location Address:
2015 NORTH JEFFERSON STREET
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-588-1480
Provider Business Practice Location Address Fax Number:
904-588-1300
Provider Enumeration Date:
12/20/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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