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General NPI Number Information
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NPI Number | 1447434873
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Entity Type | Organization
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Legal Business Name | ANDRE F.A. JAWDE, MD, PA
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 1449 MICCOSUKEE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5171
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Country | US
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Telephone | 850-942-2337
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Fax | 850-942-2843
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Provider Business Mailing Address
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Address Line | 1449 MICCOSUKEE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5171
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Country | US
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Telephone | 850-942-2337
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Fax | 850-942-2843
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANDRE FA JAWDE
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Credential | MD
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Telephone | 850-942-2337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME29007
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License Number State | FL
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