| NPI | 1053360669 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-05-09 |
| Last Updated | 2008-07-07 |
| Authorized Official | Abdul Wallizada Owner Phone: 9042760005 |
| Mailing Address | 2140 Kingsley Ave, Ste.#10 Orange Park, FL 32073-5180 United States Phone: (904) 276-0005 | Fax: (904) 276-9202 📍 View Map |
| Primary Practice Address | 2140 Kingsley Ave, Ste.#10 Orange Park, FL 32073-5180 United States Phone: (904) 276-0005 | Fax: (904) 276-9202 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | FL | 376381100 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 2080A0000X – Pediatrics, Adolescent Medicine | FL | ME0067026 |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1053360669
Abdul Khalil Wallizada,md is an organization registered in the CMS NPPES NPI Registry with NPI number 1053360669. The primary specialty listed is Pediatrics, Adolescent Medicine. The organization is located in Orange Park, FL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-05-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1053360669?
NPI 1053360669 belongs to Abdul Khalil Wallizada,md, a Pediatrics, Adolescent Medicine in Orange Park, FL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1053360669 active?
The current status of NPI 1053360669 in the NPPES registry is Active. The record was last updated on 2008-07-07.
What specialty is NPI 1053360669?
NPI 1053360669 is classified under the taxonomy Pediatrics, Adolescent Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1053360669?
You can verify NPI 1053360669 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1053360669?
The primary practice address on file for NPI 1053360669 is 2140 Kingsley Ave, Orange Park, FL 32073-5180. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1053360669 issued?
NPI 1053360669 was first issued (enumerated) on 2006-05-09. The NPPES record was last updated on 2008-07-07.
Practice Location Map
Abdul Khalil Wallizada,md is located at 2140 Kingsley Ave, Orange Park, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Abdul Khalil Wallizada,md. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1053360669. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pediatrics, Adolescent Medicine | ME0067026 | FL |