Provider Demographics
NPI:1255315875
Name:NADDAF, NAJA R (MD)
Entity Type:Individual
Prefix:
First Name:NAJA
Middle Name:R
Last Name:NADDAF
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:1689 EAGLE HARBOR PKWY E
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4817
Mailing Address - Country:US
Mailing Address - Phone:904-269-1366
Mailing Address - Fax:904-264-9750
Practice Address - Street 1:1689 EAGLE HARBOR PKWY E
Practice Address - Street 2:SUITE A
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32003-4817
Practice Address - Country:US
Practice Address - Phone:904-269-1366
Practice Address - Fax:904-264-9750
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2010-10-13
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Provider Licenses
StateLicense IDTaxonomies
FLME90385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274219500Medicaid
FL274219500Medicaid
FL48117ZMedicare PIN