Healthcare Provider Details

I. General information

NPI: 1851354559
Provider Name (Legal Business Name): JALIL THURBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9388 ABBOTT AVE
SURFSIDE FL
33154-2430
US

IV. Provider business mailing address

9388 ABBOTT AVE
SURFSIDE FL
33154-2430
US

V. Phone/Fax

Practice location:
  • Phone: 305-993-1510
  • Fax:
Mailing address:
  • Phone: 305-993-1510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberL9515
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME96017
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: