South Atlantic Retina PLLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

SOUTH ATLANTIC RETINA PLLC

Doing business as

South Atlantic Retina

Practice address

3627 University Blvd S Ste 605
Jacksonville, FL 32216-7401

Phone

(904) 658-0176

NPI assigned

Jul 25, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ahmed M Elkeeb, MD, MBANPI 1568648699

Title

Owner

Phone

(904) 658-0176

Specialties & licenses 2

Addresses

Other names 1

• South Atlantic Retina Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmed M Elkeeb, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Jacksonville, FL
  • NPI 1568648699
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779840000000",
    "number": "1033092366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S STE 605",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322167401",
            "telephone_number": "904-666-5050",
            "fax_number": "904-605-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S STE 605",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322167401",
            "telephone_number": "904-658-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATLANTIC RETINA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-25",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A",
        "authorized_official_last_name": "ELKEEB",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-658-0176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Atlantic Retina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Retina Specialist (Ophthalmology) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Retina Specialist (Ophthalmology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.