Healthcare Provider Details

I. General information

NPI: 1336924331
Provider Name (Legal Business Name): STEPHANIE HAJJAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4972 TOWN CENTER PKWY UNIT 301
JACKSONVILLE FL
32246-8596
US

IV. Provider business mailing address

4972 TOWN CENTER PKWY UNIT 301
JACKSONVILLE FL
32246-8596
US

V. Phone/Fax

Practice location:
  • Phone: 904-642-6100
  • Fax:
Mailing address:
  • Phone: 904-642-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME184350
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: