Healthcare Provider Details

I. General information

NPI: 1831284645
Provider Name (Legal Business Name): ABDALLAH I KAFROUNI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4203 BELFORT ROAD SUITE 215
JACKSONVILLE FL
32216-1416
US

IV. Provider business mailing address

4203 BELFORT ROAD SUITE 215
JACKSONVILLE FL
32216-1416
US

V. Phone/Fax

Practice location:
  • Phone: 904-354-8200
  • Fax: 904-354-1340
Mailing address:
  • Phone: 904-354-8200
  • Fax: 904-354-1340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME106716
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number38659
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD65843
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME106716
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME106716
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: