MEDICARE: FADI CHALHOUB

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	208100000X	Physical Medicine & Rehabilitation Physician	ME82883	FL
2	207R00000X	Internal Medicine Physician	ME82883	FL
3	208M00000X	Hospitalist Physician	ME82883	FL
4	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	ME82883	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	:	1568451557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FADI CHALHOUB

Provider Business Mailing Address
First Line	:	PO BOX 550763
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32255-0763
Country	:	US
Telephone Number	:	904-307-7404
Fax Number	:

Provider Business Practice Location Address
First Line	:	2436 UNIVERSITY BLVD W BLDG 6
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2002
Country	:	US
Telephone Number	:	904-916-1845
Fax Number	:	904-467-6719

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	08/21/2025

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Directions to “ FADI CHALHOUB ” Practice Location

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