Provider Demographics
NPI:1962790519
Name:KURDI, JALAL AL DEEN (MD)
Entity type:Individual
Prefix:DR
First Name:JALAL
Middle Name:AL DEEN
Last Name:KURDI
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 1:2100 NE 30TH AVE
Mailing Address - Street 2:BLDG 300 SUITE 102
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-4800
Mailing Address - Country:US
Mailing Address - Phone:352-401-6992
Mailing Address - Fax:
Practice Address - Street 1:2100 NE 30TH AVE
Practice Address - Street 2:BLDG 300 SUITE 102
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-4800
Practice Address - Country:US
Practice Address - Phone:352-401-6992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301099540207Q00000X
FLME119544207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine