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NPI Code Detail

MEDICARE: MRS. TALAT IMAM MD

MEDICARE: MRS. TALAT IMAM MD
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
1207Q00000XFamily Medicine PhysicianME71382FL

Other Identifiers

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

General Provider Information

NPI Number : 1710912654
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TALAT IMAM MD
Provider Business Mailing Address
First Line : 10058 BAYMEADOWS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-7177
Country : US
Telephone Number : 904-636-5400
Fax Number : 904-928-0654
Provider Business Practice Location Address
First Line : 10058 BAYMEADOWS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-7177
Country : US
Telephone Number : 904-636-5400
Fax Number : 904-928-0654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 12/26/2018

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Directions to “ MRS. TALAT IMAM MD” Practice Location

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