Nemou Medical LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NEMOU MEDICAL LLC

Practice address

231 Riverside Dr Unit 2309
Holly Hill, FL 32117-4964

Phone

(330) 774-3371

Fax

(888) 959-3690

NPI assigned

Aug 28, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Khalil Nemou, M.D.

Title

President

Phone

(386) 898-9801

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1043687767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 RIVERSIDE DRIVE",
            "address_2": "APT 2309",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "330-774-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 RIVERSIDE DR UNIT 2309",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321174964",
            "telephone_number": "330-774-3371",
            "fax_number": "888-959-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEMOU MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-28",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "NEMOU",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-898-9801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME 109018",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Holly Hill, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.