Individual
AISHA AMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 202-2000
(904) 281-9806
Mailing address
4466 SWILCAN BRIDGE LN N, JACKSONVILLE, FL 32224-5617
(904) 281-0944
(904) 281-9806
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125056653
IL
207R00000X
Internal Medicine Physician
Primary
ME116728
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009362500
—
FL
01
—
14SU9
BCBS
FL
Enumeration date
09/28/2011
Last updated
02/03/2014
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