=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407087455
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAWAD ELIAS FRANCIS M.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2009
-----------------------------------------------------
Last Update Date | 12/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 894 E ALTAMONTE DR
-----------------------------------------------------
City | ALTAMONTE SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32701-5002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-834-5151
-----------------------------------------------------
Fax | 407-834-5562
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 667 EASTLAND AVE SE
-----------------------------------------------------
City | WARREN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44484-4503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-841-4177
-----------------------------------------------------
Fax | 330-841-4598
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RX0202X
-----------------------------------------------------
Taxonomy Name | Medical Oncology Physician
-----------------------------------------------------
License Number | ME134820
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RX0202X
-----------------------------------------------------
Taxonomy Name | Medical Oncology Physician
-----------------------------------------------------
License Number | 35099046
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------