Provider Demographics
NPI:1164790754
Name:JAVED-EBEID, SANA (MD)
Entity Type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:JAVED-EBEID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANA
Other - Middle Name:
Other - Last Name:JAVED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:801 E 6TH ST STE 602
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3645
Practice Address - Country:US
Practice Address - Phone:850-770-3030
Practice Address - Fax:850-770-3024
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1142432084N0400X
CAA 1172072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology