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NPI Code Detail

MEDICARE: JAMEEL AUDEH

MEDICARE: JAMEEL AUDEH
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
1207RX0202XMedical Oncology PhysicianME54351FL

Other Identifiers

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

General Provider Information

NPI Number : 1104817063
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMEEL AUDEH
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line :
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8200
Fax Number :
Provider Business Practice Location Address
First Line : 1970 GOLF ST
Second Line :
City : SARASOTA
State : FL
Zip : 34236-6908
Country : US
Telephone Number : 941-957-1000
Fax Number : 941-951-2117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 08/02/2022

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