Provider Demographics
NPI:1659989531
Name:SARTIPI, MELOUDI (MD)
Entity Type:Individual
Prefix:DR
First Name:MELOUDI
Middle Name:
Last Name:SARTIPI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000-2 LEM TURNER ROAD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-4111
Mailing Address - Country:US
Mailing Address - Phone:904-539-8200
Mailing Address - Fax:904-539-8229
Practice Address - Street 1:8000-2 LEM TURNER ROAD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-4111
Practice Address - Country:US
Practice Address - Phone:904-539-8200
Practice Address - Fax:904-539-8229
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME160947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine