Healthcare Provider Details

I. General information

NPI: 1023927563
Provider Name (Legal Business Name): JUDY ASHOURI MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 UNIVERSITY BLVD W
JACKSONVILLE FL
32217-2022
US

IV. Provider business mailing address

2301 UNIVERSITY BLVD W
JACKSONVILLE FL
32217-2022
US

V. Phone/Fax

Practice location:
  • Phone: 904-874-6756
  • Fax: 904-398-3871
Mailing address:
  • Phone: 904-874-6756
  • Fax: 904-398-3871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JUDY ASHOURI
Title or Position: MANAGER
Credential: MD
Phone: 904-874-6756