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General NPI Number Information
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NPI Number | 1497880819
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Entity Type | Organization
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Legal Business Name | ISHMEAL MAJOR MD LLC
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11798 SAN JOSE BLVD SUITE 2
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City | JACKSONVILLE
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State | FL
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Zip | 32223
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Country | US
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Telephone | 904-371-4948
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Fax | 904-371-4958
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Provider Business Mailing Address
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Address Line | 11798 SAN JOSE BLVD SUITE 2
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City | JACKSONVILLE
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State | FL
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Zip | 32223
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Country | US
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Telephone | 904-371-4948
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Fax | 904-371-4958
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Authorized Official
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Title or Position | OWNER
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Name | DR. ISHMEAL MAJOR
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Credential | M.D.
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Telephone | 904-254-9643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME94659
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License Number State | FL
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