Healthcare Provider Details

I. General information

NPI: 1104104637
Provider Name (Legal Business Name): FERAS JALAB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MOHAMMED FERAS JALAB

II. Dates (important events)

Enumeration Date: 08/02/2011
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 NE 168TH ST APT 106A
NORTH MIAMI BEACH FL
33160-3541
US

IV. Provider business mailing address

4040 E CAMELBACK RD STE 250
PHOENIX AZ
85018-8350
US

V. Phone/Fax

Practice location:
  • Phone: 855-687-7237
  • Fax:
Mailing address:
  • Phone: 855-687-7237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberS8048
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number14398C
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME154417
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number18348
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: