Provider Demographics
NPI:1104873355
Name:ADAM-ELDIEN, RABIE IBRAHIM (MD)
Entity type:Individual
Prefix:DR
First Name:RABIE
Middle Name:IBRAHIM
Last Name:ADAM-ELDIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 UNIVERSITY BLVD S
Mailing Address - Street 2:STE E
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4320
Mailing Address - Country:US
Mailing Address - Phone:904-744-4448
Mailing Address - Fax:904-744-4048
Practice Address - Street 1:4123 UNIVERSITY BLVD S
Practice Address - Street 2:STE E
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-744-4448
Practice Address - Fax:904-744-4048
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN55776207P00000X, 208M00000X, 207RN0300X
FLME119980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine