MEDICARE: DR. JOSSIE ALIYAH MCCLOUD D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS9218	FL
2	207Q00000X	Family Medicine Physician	56802	GA
3	207Q00000X	Family Medicine Physician	5101027087	MI
4	207Q00000X	Family Medicine Physician	1019043	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033161799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSSIE ALIYAH MCCLOUD D.O.

Provider Business Mailing Address
First Line	:	7643 GATE PKWY STE 104-1877
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-3092
Country	:	US
Telephone Number	:	904-990-3711
Fax Number	:

Provider Business Practice Location Address
First Line	:	7643 GATE PKWY STE 104-1877
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-3092
Country	:	US
Telephone Number	:	904-990-3711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	12/30/2025

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