Dr Fatah Abdul Wallizada, MD - Pediatrics in Jacksonville, FL

Dr Fatah Abdul Wallizada, MD is a Pediatrics physician based in Jacksonville, Florida. Dr Fatah Abdul Wallizada is licensed to practice in Florida (license number ME0062087) and his current practice location is 1395 Cassat Ave, Suite# 1, Jacksonville, Florida. He can be reached at his office (for appointments etc.) via phone at (904) 388-5832.

NPI number for Dr Fatah Abdul Wallizada is 1255351599 and his current mailing address is 1395 Cassat Ave, Suite# 1, Jacksonville, Florida. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1255351599.

Contact Information

Dr Fatah Abdul Wallizada, MD
1395 Cassat Ave, Suite# 1,
Jacksonville, FL 32205-9616
(904) 388-5832
(904) 388-6270

Map and Direction




Physician's Profile

Full NameDr Fatah Abdul Wallizada
GenderMale
SpecialityPediatrics
Location1395 Cassat Ave, Jacksonville, Florida
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1255351599
  • Provider Enumeration Date: 07/20/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Dr Fatah Abdul Wallizada such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255351599NPI-NPPES
371234600MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics ME0062087 (Florida)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Fatah Abdul Wallizada is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Fatah Abdul Wallizada, MD
1395 Cassat Ave, Suite# 1,
Jacksonville, FL 32205-9616

Ph: (904) 388-5832
Dr Fatah Abdul Wallizada, MD
1395 Cassat Ave, Suite# 1,
Jacksonville, FL 32205-9616

Ph: (904) 388-5832

Reviews and Comments


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