# MAMOON JARRAH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1699719468
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | ME0040565 | FL | Yes |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 02/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 066974100 | — | FL |
| 01 | — | 08118 | COMMERCIAL | FL |
| 01 | — | 4652614 | AETNA | FL |
| 01 | — | 5744032-004 | CIGNA | FL |
| 01 | — | 629729 | ANTHEM | FL |
| 01 | — | 629729 | BCBS TENNESSEE | TN |
| 01 | — | 770002062 | RR MEDICARE | FL |