A E Deeb MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25682 Issued in FL

Legal business name

A E DEEB MD PA

Practice address

1630 N Plaza Dr
Tallahassee, FL 32308-5346

Phone

(850) 877-6324

NPI assigned

May 10, 2007

Last updated

Mar 26, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Al Elias Deeb, M.D.NPI 1306891239

Title

Owner

Phone

(850) 877-6324

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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.

• Al E. Deeb

  • Surgery Physician
  • Tallahassee, FL
  • NPI 1306891239
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1316151194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 N PLAZA DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085346",
            "telephone_number": "850-877-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 N PLAZA DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085346",
            "telephone_number": "850-877-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A E DEEB MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "DEEB",
        "authorized_official_first_name": "AL",
        "authorized_official_middle_name": "ELIAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-877-6324",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "25682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA MCD ID",
            "identifier": "00145274A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.