Healthcare Provider Details

I. General information

NPI: 1871483925
Provider Name (Legal Business Name): ABDULLAH ALJABBAN RMFTI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2808 ENTERPRISE RD STE 105
DEBARY FL
32713-2753
US

IV. Provider business mailing address

2808 ENTERPRISE RD STE 105
DEBARY FL
32713-2753
US

V. Phone/Fax

Practice location:
  • Phone: 386-668-4774
  • Fax:
Mailing address:
  • Phone: 386-668-4774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: