Healthcare Provider Details

I. General information

NPI: 1225601818
Provider Name (Legal Business Name): ABDEL RAHMAN SAMIH A JABER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 SOUTHERN BLVD
LOXAHATCHEE FL
33470-9203
US

IV. Provider business mailing address

13001 SOUTHERN BLVD
LOXAHATCHEE FL
33470-9203
US

V. Phone/Fax

Practice location:
  • Phone: 561-905-6352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number33112
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: