Individual
FARA NADAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5491 DOLPHIN POINT BLVD STE 3110, JACKSONVILLE, FL 32211-3221
(904) 744-5244
(904) 390-7474
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME61612
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379291900
—
FL
01
—
P00112716
RR MEDICARE
FL
Enumeration date
02/03/2006
Last updated
11/21/2024
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