Organization
MOHAMED H ANTAR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED H ANTAR MD (PRESIDENT)
(904) 384-8733
Entity
Organization
Contact information
Practice address
2150 PARK ST, JACKSONVILLE, FL 32204-3812
(904) 384-8733
(904) 384-9004
Mailing address
2150 PARK ST, JACKSONVILLE, FL 32204-3812
(904) 384-8733
(904) 384-9004
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME23316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71753
BCBS GROUP #
FL
Enumeration date
12/08/2006
Last updated
07/17/2014
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