Healthcare Provider Details

I. General information

NPI: 1730169863
Provider Name (Legal Business Name): RAMEZ TAHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10460 PHILIPS HWY
JACKSONVILLE FL
32256
US

IV. Provider business mailing address

10460 PHILIPS HWY
JACKSONVILLE FL
32256
US

V. Phone/Fax

Practice location:
  • Phone: 904-472-5678
  • Fax:
Mailing address:
  • Phone: 904-472-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME101043
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME101043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: