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General NPI Number Information
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NPI Number | 1568451557
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Entity Type | Individual
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Provider Name | FADI CHALHOUB
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Gender | Male
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 2436 UNIVERSITY BLVD W BLDG 6
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2002
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Country | US
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Telephone | 904-916-1845
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Fax | 904-467-6719
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Provider Business Mailing Address
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Address Line | PO BOX 550763
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City | JACKSONVILLE
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State | FL
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Zip | 32255-0763
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Country | US
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Telephone | 904-307-7404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME82883
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME82883
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME82883
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME82883
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License Number State | FL
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