Provider Demographics
NPI:1649668096
Name:JAMALDIN, FARHA MOHAMED HAJI
Entity type:Individual
Prefix:
First Name:FARHA
Middle Name:MOHAMED HAJI
Last Name:JAMALDIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 SILVER CREEK CIR APT 4
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1973
Mailing Address - Country:US
Mailing Address - Phone:904-899-3270
Mailing Address - Fax:
Practice Address - Street 1:999 CROSSWATER PKWY
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32081-1800
Practice Address - Country:US
Practice Address - Phone:904-686-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT25085225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist