Healthcare Provider Details

I. General information

NPI: 1144462326
Provider Name (Legal Business Name): JABARI DAVID CAPP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19809 NW 67TH CT
HIALEAH FL
33015
US

IV. Provider business mailing address

19809 NW 67TH CT
HIALEAH FL
33015-2415
US

V. Phone/Fax

Practice location:
  • Phone: 305-803-2966
  • Fax:
Mailing address:
  • Phone: 305-803-2966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number81118
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberTP840
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: