Provider Demographics
NPI:1306875422
Name:EL BAHRI, GEORGES ABDO (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGES
Middle Name:ABDO
Last Name:EL BAHRI
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 1:6100 KENNERLY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4368
Mailing Address - Country:US
Mailing Address - Phone:904-739-0050
Mailing Address - Fax:904-828-4605
Practice Address - Street 1:6100 KENNERLY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4368
Practice Address - Country:US
Practice Address - Phone:904-739-0050
Practice Address - Fax:904-828-4605
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0027372207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50899Medicare UPIN
FL04019YMedicare ID - Type Unspecified