M. KHAL ABOUDAN MD NPI 1255489597

NPI Information

NPI: 1255489597
Provider Name: M. KHAL ABOUDAN, MD

Doing Business As: M. KHAL ABOUDAN MD

Classification: Emergency Medicine - 207PP0204X
Entity Type: Organization

Specialization: Pediatric Emergency Medicine

Address:
800 PRUDENTIAL DR
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 396-5682
Get Directions

M. KHAL ABOUDAN, MD is a pediatric emergency medicine emergency medicine in Jacksonville, FL. The provider is pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. M. KHAL ABOUDAN, MD NPI is 1255489597. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As M. Khal Aboudan Md.

The provider's business location address is:

800 PRUDENTIAL DR
JACKSONVILLE, FL
ZIP 32207-202
Phone: (904) 396-5682
Fax: (904) 346-0864

The provider's authorized official is M. Khal Aboudan .
The authorized official title is Md and has the following contact phone number (904) 396-5682.

The enumeration date for this NPI number is 1/5/2007 and was last updated on 3/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207PP0204X	Emergency Medicine	Pediatric Emergency Medicine	ME45711	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02583	OTHER	FLORIDA	BCBS OF FL
2	E12128	MEDICARE UPIN	FLORIDA
3	00687475A	MEDICAID	GEORGIA
4	02583B	MEDICARE PIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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