Healthcare Provider Details

I. General information

NPI: 1174719322
Provider Name (Legal Business Name): DALIA ELRAMADY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6817 SOUTHPOINT PKWY STE 1302
JACKSONVILLE FL
32216-6297
US

IV. Provider business mailing address

PO BOX 550587
JACKSONVILLE FL
32255-0587
US

V. Phone/Fax

Practice location:
  • Phone: 904-902-0091
  • Fax: 904-600-5299
Mailing address:
  • Phone: 904-646-9267
  • Fax: 904-646-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME107219
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTRN 11568
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME107219
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: