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General NPI Number Information
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NPI Number | 1780987024
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Entity Type | Organization
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Legal Business Name | RANIA ABDEL-RAHMAN MD PLLC
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Dates
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Enumeration Date | 12/08/2010
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 4168 SOUTHPOINT PKWY S SUITE 103
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City | JACKSONVILLE
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State | FL
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Zip | 32216-0966
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Country | US
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Telephone | 904-551-1185
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Fax |
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Provider Business Mailing Address
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Address Line | 4168 SOUTHPOINT PKWY S SUITE 103
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City | JACKSONVILLE
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State | FL
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Zip | 32216-0966
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Country | US
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Telephone | 904-551-1185
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Fax |
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Authorized Official
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Title or Position | MANAGER/MEMBER
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Name | DR. RANIA ABDEL-RAHMAN
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Credential | MD
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Telephone | 904-551-1185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME106215
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License Number State | FL
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