Individual
DR. IMAD V EL-JASSOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 N US HIGHWAY 441 STE 924, THE VILLAGES, FL 32159-6812
(352) 633-8319
(352) 633-8434
Mailing address
PO BOX 102222, ATTN: CREDENTIALING DEPT., ATLANTA, GA 30368-2222
(239) 274-8200
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME100380
FL
207RX0202X
Medical Oncology Physician
Primary
ME100380
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000991700
—
FL
Enumeration date
07/25/2008
Last updated
08/03/2022
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