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General NPI Number Information
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NPI Number | 1851856975
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Entity Type | Organization
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Legal Business Name | AKSHARBRAHMA PA
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Dates
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Enumeration Date | 02/02/2019
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 6100 GREENLAND RD STE 301
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City | JACKSONVILLE
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State | FL
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Zip | 32258-2626
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Country | US
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Telephone | 904-257-6264
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Fax | 904-293-1326
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Provider Business Mailing Address
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Address Line | 6100 GREENLAND RD STE 301
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City | JACKSONVILLE
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State | FL
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Zip | 32258-2626
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Country | US
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Telephone | 904-257-6264
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Fax | 904-293-1326
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Authorized Official
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Title or Position | PRESIDENT
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Name | ASHISH PATEL
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Credential | MD, FAAP
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Telephone | 904-257-6264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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