Provider Demographics
NPI:1477041796
Name:ABDELAL, QASSEM KHALED (MD)
Entity Type:Individual
Prefix:
First Name:QASSEM
Middle Name:KHALED
Last Name:ABDELAL
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:655 WEST 8TH STREET
Mailing Address - Street 2:C54, 7TH FLOOR, CLINICAL CENTER
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209
Mailing Address - Country:US
Mailing Address - Phone:904-244-1658
Mailing Address - Fax:904-244-1681
Practice Address - Street 1:655 WEST 8TH STREET
Practice Address - Street 2:C54, 7TH FLOOR, CLINICAL CENTER
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-244-1658
Practice Address - Fax:904-244-1681
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME150624207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine