NPIMap

Organization Active NPI

Mohamed H Antar MD PA

  • Urology Physician
  • Jacksonville, FL
National Provider Identifier
1225197916
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME23316 Issued in FL
Legal business name
MOHAMED H ANTAR MD PA
Practice address
2150 Park St
Jacksonville, FL 32204-3812
Phone
(904) 384-8733
Fax
(904) 384-9004
NPI assigned
Dec 8, 2006
Last updated
Jul 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Mohamed H Antar, MDNPI 1972580298
Title
President
Phone
(904) 384-8733

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME23316 FL Primary

Addresses

Primary practice location

2150 Park St
Jacksonville, FL 32204-3812

Mailing address

2150 Park St
Jacksonville, FL 32204-3812
Phone (904) 384-8733

Other identifiers 1

IdentifierTypeStateIssuer
71753OtherFLBCBS GROUP #

National Provider Directory

National Provider Directory

Locations

2150 Park St
Jacksonville, FL 32204
Phone (904) 384-8733

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1225197916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043812",
            "telephone_number": "904-384-8733",
            "fax_number": "904-384-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043812",
            "telephone_number": "904-384-8733",
            "fax_number": "904-384-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMED H ANTAR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "ANTAR",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-384-8733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME23316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "71753",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.