Basic Information
Provider Information
NPI: 1841224169
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASHARAF
FirstName: ABDUL RASHEED
MiddleName: RASHEED
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 RIVERPLACE BLVD
Address2: SUITE 620
City: JACKSONVILLE
State: FL
PostalCode: 322079046
CountryCode: US
TelephoneNumber: 9043966620
FaxNumber: 9043966528
Practice Location
Address1: 1200 RIVERPLACE BLVD
Address2: SUITE 620
City: JACKSONVILLE
State: FL
PostalCode: 322079046
CountryCode: US
TelephoneNumber: 9043966620
FaxNumber: 9043966528
Other Information
ProviderEnumerationDate: 07/11/2006
LastUpdateDate: 01/07/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD00046655WAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XME107521FLY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
P0034280301WARR MEDICAREOTHER
846405905WA MEDICAID


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