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General NPI Number Information
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NPI Number | 1629573290
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Entity Type | Individual
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Provider Name | JAHAN JONATHAN RAD MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 350 7TH ST N
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City | NAPLES
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State | FL
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Zip | 34102-5754
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Country | US
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Telephone | 239-624-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1378 11TH CT N
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City | NAPLES
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State | FL
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Zip | 34102-5224
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Country | US
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Telephone | 404-944-0309
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | T1816
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 76353
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 89400
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME149795
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License Number State | FL
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