Individual
AMALIE FAOUZI EID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4205 BELFORT RD STE 2005, JACKSONVILLE, FL 32216-5876
(904) 450-6140
(904) 450-6137
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 296-5691
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11013150A
IN
207RG0100X
Gastroenterology Physician
Primary
ME111620
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124361A
—
GA
05
—
005581400
—
FL
01
—
14K64
BCBS
FL
Enumeration date
06/11/2008
Last updated
01/05/2018
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