Healthcare Provider Details

I. General information

NPI: 1962790519
Provider Name (Legal Business Name): JALAL AL DEEN KURDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 REW CIR STE 200
OCOEE FL
34761-2967
US

IV. Provider business mailing address

2710 REW CIR STE 200
OCOEE FL
34761-2967
US

V. Phone/Fax

Practice location:
  • Phone: 813-317-5674
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME119544
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: