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General NPI Number Information
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NPI Number | 1700844420
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Entity Type | Individual
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Provider Name | KARIM JACOB SAMARA MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 3316 3RD ST S SUITE 103
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City | JACKSONVILLE
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State | FL
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Zip | 32250-6073
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Country | US
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Telephone | 904-241-7865
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Fax |
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Provider Business Mailing Address
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Address Line | 3316 3RD ST S SUITE 103
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City | JACKSONVILLE
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State | FL
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Zip | 32250-6073
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Country | US
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Telephone | 904-241-7865
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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 | ME91598
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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 | ME91598
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME91598
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License Number State | FL
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