Provider Demographics
NPI:1376074286
Name:ABADEER, KEROLOS (MD)
Entity type:Individual
Prefix:
First Name:KEROLOS
Middle Name:
Last Name:ABADEER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KEROLOS
Other - Middle Name:
Other - Last Name:ABADEER SEDKI SENADA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4800 BELFORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6004
Mailing Address - Country:US
Mailing Address - Phone:904-398-3385
Mailing Address - Fax:904-265-4807
Practice Address - Street 1:805 WELLS RD
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-2301
Practice Address - Country:US
Practice Address - Phone:042-649-7979
Practice Address - Fax:904-264-4644
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME161157207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program