Mamoon Jarrah MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0040565 Issued in FL

Legal business name

MAMOON JARRAH MD PA

Practice address

2525 Harbor Blvd
Suite 202
Port Charlotte, FL 33952-5317

Phone

(941) 613-3773

Fax

(941) 629-6770

NPI assigned

Nov 8, 2007

Organization subpart

No

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

Authorized official

Name

Kristy Smith

Title

Office Manager

Phone

(941) 613-3773

Specialties & licenses 1

Addresses

Other names 1

• M. Jarrah MD PA Doing business as

Locations

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1487834263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 HARBOR BLVD",
            "address_2": "SUITE 202",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525317",
            "telephone_number": "941-613-3773",
            "fax_number": "941-629-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 HARBOR BLVD",
            "address_2": "SUITE 202",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525317",
            "telephone_number": "941-613-3773",
            "fax_number": "941-629-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMOON JARRAH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "941-613-3773"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0040565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M. Jarrah MD PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Providers in Port Charlotte, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.