| Promed Clinic | |
|
1907 Atlantic Blvd Jacksonville FL 32207-3466 | |
| (904) 388-4712 | |
| Not Available |
| Full Name | Promed Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 1907 Atlantic Blvd, Jacksonville, Florida |
| Authorized Official Name and Position | Haissam Barakat (PRESIDENT) |
| Authorized Official Contact | 9049626005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Promed Clinic 1462 Flanders Rd Jacksonville FL 32207-1904 Ph: (904) 388-4712 | Promed Clinic 1907 Atlantic Blvd Jacksonville FL 32207-3466 Ph: (904) 388-4712 |
| NPI Number | 1629499090 |
|---|---|
| Provider Enumeration Date | 01/02/2014 |
| Last Update Date | 01/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629499090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 207RN0300X | Internal Medicine - Nephrology | () | Secondary |
| 208C00000X | Colon & Rectal Surgery | () | Secondary |
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