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General NPI Number Information
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NPI Number | 1932104031
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Entity Type | Individual
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Provider Name | SADIR JUMAA ALRAWI MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 7751 BAYMEADOWS RD E
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City | JACKSONVILLE
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State | FL
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Zip | 32256-5834
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Country | US
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Telephone | 904-562-4360
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Fax | 904-645-5856
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD ATTN: MANAGED CARE DEPT.
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 227687
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME96950
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License Number State | FL
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