Provider Demographics
NPI:1386924298
Name:EL-BAHRI, GEORGE (DO)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:EL-BAHRI
Suffix:
Gender:M
Credentials:DO
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 STE 101
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4376
Mailing Address - Country:US
Mailing Address - Phone:904-739-0050
Mailing Address - Fax:
Practice Address - Street 1:6100 KENNERLY RD STE 101
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4376
Practice Address - Country:US
Practice Address - Phone:904-739-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11856207X00000X
FLUO2787208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice