Provider Demographics
NPI:1609147560
Name:YOUNES, AHMAD TOUFIC (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:TOUFIC
Last Name:YOUNES
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 551308
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32255-1308
Mailing Address - Country:US
Mailing Address - Phone:904-622-9040
Mailing Address - Fax:904-309-5691
Practice Address - Street 1:1681 EAGLE HARBOR PKWY STE B
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4819
Practice Address - Country:US
Practice Address - Phone:904-644-0092
Practice Address - Fax:904-644-0099
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME145487207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106505600Medicaid