Provider Demographics
NPI:1134805120
Name:ISRAEL, SA'DIEYA MAHLAH
Entity type:Individual
Prefix:
First Name:SA'DIEYA
Middle Name:MAHLAH
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 UNIVERSITY BLVD N APT 30
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-3239
Mailing Address - Country:US
Mailing Address - Phone:904-763-5183
Mailing Address - Fax:
Practice Address - Street 1:2260 UNIVERSITY BLVD N APT 30
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-3239
Practice Address - Country:US
Practice Address - Phone:904-763-5183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula