DR. MOHAMMAD ILYAS M.D. NPI 1104895416

NPI Information

NPI: 1104895416
Provider Name: DR. MOHAMMAD ILYAS, M.D.
Classification: Pediatrics - 2080P0210X
Entity Type: Individual

Specialization: Pediatric Nephrology

PECOS Registration: Yes

Address:
820 PRUDENTIAL DR STE 405
UFJP PEDIATRIC MULTISPECIALTY
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 633-0920
Get Directions

DR. Mohammad Ilyas, M.D. is a pediatric nephrology pediatrics in Jacksonville, FL with 35 years of experience. The provider is a pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. DR. Mohammad Ilyas, M.D. NPI is 1104895416. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

820 PRUDENTIAL DR STE 405
UFJP PEDIATRIC MULTISPECIALTY
JACKSONVILLE, FL
ZIP 32207-206
Phone: (904) 633-0920
Fax: (904) 600-0921

The NPI 1104895416 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/17/2006 and was last updated on 4/1/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		ME75454	FLORIDA	No
2	2080P0210X	Pediatrics	Pediatric Nephrology	ME75454	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	370020436	OTHER	FLORIDA	RAILROAD MEDICARE
2	2593840-00	MEDICAID	FLORIDA
3	000923898A	MEDICAID	GEORGIA
4	49341Y	MEDICARE PIN	FLORIDA
5	H24357	MEDICARE UPIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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