Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME91260 | FL |
Y | 2080P0203X | Pediatric Critical Care Doctor | ME91260 | FL |
NPI | 1104894419 |
---|---|
Provider Name | Dr. Javed Iqbal Akhtar |
First Address | Jacksonville, FL 32231-4008 |
Second Address | Jacksonville, FL 32207-8202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2006 |
Last Update Date | 15/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000914757B | (05) | GA |
000914757C | (05) | GA |
2705931-00 | (05) | FL |
H42964 | (02) | FL |