Individual
DR. OM P KAPOOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4131 UNIVERSITY BLVD S STE 3, JACKSONVILLE, FL 32216-4346
(904) 312-9201
(904) 312-9202
Mailing address
10981 HICKORY TRACE LN, JACKSONVILLE, FL 32256-2319
(904) 312-9201
(904) 312-9202
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
ME101418
FL
207R00000X
Internal Medicine Physician
ME101418
FL
207RI0200X
Infectious Disease Physician
Primary
ME101418
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281253300
—
FL
01
—
P00641042
RAILROAD MEDICARE
FL
Enumeration date
06/02/2006
Last updated
09/16/2020
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