Provider Demographics
NPI:1891141925
Name:NORTHEAST FLORIDA HEALTH SOLUTION INC.
Entity Type:Organization
Organization Name:NORTHEAST FLORIDA HEALTH SOLUTION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MD BASHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-388-2540
Mailing Address - Street 1:7901 JAMES ISLAND TRL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7379
Mailing Address - Country:US
Mailing Address - Phone:904-803-7395
Mailing Address - Fax:
Practice Address - Street 1:2149 SAINT JOHNS AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4418
Practice Address - Country:US
Practice Address - Phone:904-388-2540
Practice Address - Fax:904-387-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-07
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89832207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty