Individual
ANTENEH M FEYISSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(832) 348-3412
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
Primary
ME128928
FL
2084N0400X
Neurology Physician
ME 128928
FL
Other
Enumeration date
07/02/2010
Last updated
07/31/2024
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