MEDICARE: DR. MOHAMAD KHALID JIBAWI M.D.

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	208M00000X	Hospitalist Physician	ME127256	FL
2	207Q00000X	Family Medicine Physician	ME127256	FL

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

General Provider Information

NPI Number	:	1114361441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMAD KHALID JIBAWI M.D.

Provider Business Mailing Address
First Line	:	5400 PINEHURST DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-3833
Country	:	US
Telephone Number	:	727-271-8725
Fax Number	:	352-606-2857

Provider Business Practice Location Address
First Line	:	5522 TROUBLE CREEK RD STE 102
Second Line	:
City	:	NEW PRT RCHY
State	:	FL
Zip	:	34652-5171
Country	:	US
Telephone Number	:	727-788-3070
Fax Number	:	727-788-3072

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

Provider Enumeration Date	:	04/17/2013
Last Update Date	:	06/12/2025

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Directions to “ DR. MOHAMAD KHALID JIBAWI M.D.” Practice Location

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