Healthcare Provider Details

I. General information

NPI: 1639593213
Provider Name (Legal Business Name): NORTH FLORIDA MULTISPECIALTY PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8245 BAYBERRY RD
JACKSONVILLE FL
32256-7432
US

IV. Provider business mailing address

8245 BAYBERRY RD
JACKSONVILLE FL
32256-7432
US

V. Phone/Fax

Practice location:
  • Phone: 904-296-7775
  • Fax:
Mailing address:
  • Phone: 904-296-7775
  • Fax: 904-296-7760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number10D2094132
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ABDUL KANI
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 904-296-7775