Provider Demographics
NPI:1376713727
Name:JOOMA, NURUDDIN (MD)
Entity Type:Individual
Prefix:
First Name:NURUDDIN
Middle Name:
Last Name:JOOMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:400 PINELLAS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3312
Practice Address - Country:US
Practice Address - Phone:727-447-8100
Practice Address - Fax:727-461-2603
Is Sole Proprietor?:No
Enumeration Date:2008-03-01
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101795207RX0202X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000272700Medicaid
11023OtherBLUE CROSS / BLUE SHIELD
000178200OtherPHYSICIANS MEDICAID NUMBER WITH MULTIPLAN ONLY AND NOT STRAIGHT MEDICAID NUMBER
FLP00901739OtherRAILROAD MEDICARE
FLP00615863OtherMEDICARE RR
FLP00615863OtherMEDICARE RR
FL000272700Medicaid
FLAL066XMedicare PIN
FLAL0662Medicare PIN