Provider Demographics
NPI:1437485786
Name:IBRAHIM, MORHAF (MD)
Entity Type:Individual
Prefix:
First Name:MORHAF
Middle Name:
Last Name:IBRAHIM
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 1:5150 BELFORT RD BLDG 400
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6026
Mailing Address - Country:US
Mailing Address - Phone:904-580-4730
Mailing Address - Fax:904-589-4740
Practice Address - Street 1:5150 BELFORT RD
Practice Address - Street 2:BLDG 400
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6026
Practice Address - Country:US
Practice Address - Phone:904-580-4730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115300207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14S95OtherBCBS
FL009577000Medicaid
FL14S95OtherBCBS