Provider Demographics
NPI:1972647311
Name:JAMALEDDINE, WAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:WAEL
Middle Name:A
Last Name:JAMALEDDINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:33044 HWY 27
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-7621
Mailing Address - Country:US
Mailing Address - Phone:863-422-4977
Mailing Address - Fax:863-422-7786
Practice Address - Street 1:3145 CITRUS TOWER BLVD STE B
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6889
Practice Address - Country:US
Practice Address - Phone:352-900-5227
Practice Address - Fax:352-308-3159
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME62749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080108263OtherRAILROAD MEDICARE
FL6871531OtherCIGNA
FL18170OtherBCBS
FL2519097-00Medicaid
FL18170OtherBCBS
FL18170BMedicare ID - Type Unspecified