DR. FATAH ABDUL WALLIZADA M.D. - NPI 1255351599 - Pediatrics in Jacksonville, FL

Q: What is Fatah Wallizada's NPI number?

The NPI number for Fatah Wallizada is 1255351599. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Q: What is Fatah Wallizada's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Fatah Wallizada was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Dr. Fatah Abdul Wallizada M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. FATAH ABDUL WALLIZADA M.D. (NPI 1255351599) is an individual pediatrics provider in Jacksonville, Florida, licensed in Florida (ME0062087) and active in the NPI registry since July 2006. He holds a CLIA Waiver certificate valid through January 25, 2028.

NPPES Registry Identity

NPI1255351599

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. FATAH ABDUL WALLIZADACredential: M.D.

Location Address1395 CASSAT AVE, SUITE# 1Jacksonville, FL 32205-9616

Mailing Address1395 Cassat Ave, Suite# 1Jacksonville, FL 32205-9616 · (904) 388-5832 · Fax (904) 388-6270

Phone(904) 388-5832

Fax(904) 388-6270

Sole ProprietorYes

Enumeration DateJuly 20, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1255351599 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in FL · ME0062087

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1395 CASSAT AVE, Jacksonville, FL 32205

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0881997

Fatah A Wallizada MD · Jacksonville, FL

Active · expires Jan 25, 2028

CLIA Number10D0881997

Laboratory TypePhysician Office

Certificate Effective DateJanuary 26, 2026

Certificate Expiration DateJanuary 25, 2028

Laboratory DirectorFatah A. Wallizada MD

Laboratory Phone(904) 388-5832

Laboratory LocationFatah A Wallizada MD2260 Cassat Ave, Jacksonville, FL 32210

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

URGENTIUM LLC

Clinic/Center (Urgent Care)

1395 CASSAT AVE, 1
JACKSONVILLE, FL 32205

Duval County (904) 607-2635

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fatah Wallizada's NPI number?

The NPI number for Fatah Wallizada is 1255351599. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Where is Fatah Wallizada located?

Fatah Wallizada practices at 1395 Cassat Ave Suite# 1, Jacksonville, FL 32205. The listed phone number is (904) 388-5832.

What is Fatah Wallizada's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Fatah Wallizada hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0881997) is associated with this NPI, valid through January 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fatah Wallizada accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Fatah Wallizada as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fatah Wallizada was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.