M. Khal Aboudan, MD

Primary specialty

Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X

License

ME45711 Issued in FL

Legal business name

M. KHAL ABOUDAN, MD

Practice address

800 Prudential Dr
Jacksonville, FL 32207-8202

Phone

(904) 396-5682

Fax

(904) 346-0864

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. M. Khal Aboudan, MD

Title

MD

Phone

(904) 396-5682

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• M. Khal Aboudan MD Doing business as

Locations

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1255489597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 713",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078209",
            "telephone_number": "904-396-5682",
            "fax_number": "904-346-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-396-5682",
            "fax_number": "904-346-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. KHAL ABOUDAN, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "ABOUDAN",
        "authorized_official_first_name": "M. KHAL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "904-396-5682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME45711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00687475A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "02583",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M. Khal Aboudan MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lysandro O. Tapnio DMD PA
• Sydnie Lee Lytle, PA-C
• Megan Lytus, DO
• M & M Rehab Inc
• M Nan Jobson PA
• M.W. Kilgore, II, M.D., P.a.
• M'Bodi LLC
• M&D Provider Services, Inc
• M&M Supportive Living Services
• Naji Maaliki, MD

• Pediatric Emergency Medicine (Emergency Medicine) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Emergency Medicine (Emergency Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.