Organization
JACKSONVILLE PSYCHIATRIC ASSOCIATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMTIAZ RASUL MD (OWNER)
(973) 901-0394
Entity
Organization
Contact information
Practice address
10175 FORTUNE PKWY, SUITE 206, JACKSONVILLE, FL 32256-6746
(904) 379-8748
(904) 379-8796
Mailing address
10175 FORTUNE PKWY, SUITE 206, JACKSONVILLE, FL 32256-6746
(973) 901-0394
(941) 205-2422
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME112178
FL
Other
Enumeration date
09/03/2013
Last updated
09/11/2025
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