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General NPI Number Information
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NPI Number | 1780804500
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Entity Type | Organization
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Legal Business Name | AKRA PROFESSIONAL SERVICES
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 1551 ATLANTIC BLVD SUITE 101
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3359
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Country | US
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Telephone | 904-379-9327
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Fax | 904-379-3764
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Provider Business Mailing Address
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Address Line | 1551 ATLANTIC BLVD SUITE 101
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3359
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Country | US
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Telephone | 904-379-9327
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Fax | 904-379-3764
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LOUIS ANTHONY AKRA
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Credential | MD
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Telephone | 904-379-9327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME66955
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License Number State | FL
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