Individual
DR. IMTIAZ RASUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10175 FORTUNE PKWY, SUITE 206, JACKSONVILLE, FL 32256-6746
(904) 379-8748
(904) 379-8796
Mailing address
10175 FORTUNE PKWY UNIT 206, JACKSONVILLE, FL 32256-6748
(904) 379-8748
(904) 379-8796
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME-112178
FL
Other
Enumeration date
12/12/2008
Last updated
10/10/2025
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