Provider Demographics
NPI:1497851042
Name:ASAD, SYED A (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:A
Last Name:ASAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8823 SAN JOSE BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4288
Mailing Address - Country:US
Mailing Address - Phone:904-404-7044
Mailing Address - Fax:904-329-2303
Practice Address - Street 1:8823 SAN JOSE BLVD STE 209
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4288
Practice Address - Country:US
Practice Address - Phone:904-404-7044
Practice Address - Fax:904-329-2303
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93143207U00000X, 2084N0400X
GA0517772084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001790100Medicaid
FL001790100Medicaid
FLI43763Medicare UPIN