MEDICARE: ABDALLAH I KAFROUNI 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	207R00000X	Internal Medicine Physician	D65843	MD
2	207R00000X	Internal Medicine Physician	38659	KY
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME106716	FL
4	207RP1001X	Pulmonary Disease Physician	ME106716	FL
5	208M00000X	Hospitalist Physician	ME106716	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00669592	OTHER	MD	R/R MEDICARE PIN
3	CN6601	OTHER	MD	R/R GROUP MEDICARE PIN

Other Identifiers

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

General Provider Information

NPI Number	:	1831284645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDALLAH I KAFROUNI M.D.

Provider Business Mailing Address
First Line	:	4203 BELFORT ROAD
Second Line	:	SUITE 215
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1416
Country	:	US
Telephone Number	:	904-354-8200
Fax Number	:	904-354-1340

Provider Business Practice Location Address
First Line	:	4203 BELFORT ROAD
Second Line	:	SUITE 215
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1416
Country	:	US
Telephone Number	:	904-354-8200
Fax Number	:	904-354-1340

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	04/16/2026

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