Individual
AHMAD SOUHEIL JALLOUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3121 CITRUS TOWER BLVD, CLERMONT, FL 34711-6881
(352) 404-5968
(877) 762-7377
Mailing address
PO BOX 386, TAVARES, FL 32778-0386
(352) 404-5986
(877) 762-7377
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME97922
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME97922
FL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
ME97922
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277784300
—
FL
Enumeration date
07/18/2006
Last updated
02/25/2015
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