JOHNATHAN AZAR MD
NPI 1700588258
Student in an Organized Health Care Education/Training Program in Orange Park, FL

Q: What is Johnathan Azar's NPI number?

The NPI number for Johnathan Azar is 1700588258. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Q: What is Johnathan Azar's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Johnathan Azar was last updated on March 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since March 20, 2023PECOS Enrolled

2001 KINGSLEY AVE, ORANGE PARK, FL 32073(904) 639-8242 Get Directions Write a Review

NPPES record last updated: March 20, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Johnathan Azar Md NPPES

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

JOHNATHAN AZAR MD (NPI 1700588258) is an individual student in an organized health care education/training program in Orange Park, Florida and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700588258

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJOHNATHAN AZARCredential: MD

Location Address2001 KINGSLEY AVEOrange Park, FL 32073-5148

Mailing Address4432 Ellipse DrJacksonville, FL 32246-7450

Phone(904) 639-8242

Sole ProprietorYes

Enumeration DateMarch 20, 2023

NPPES CertifiedMarch 20, 2023

✔ NPI 1700588258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2001 KINGSLEY AVE, Orange Park, FL 32073

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johnathan Azar Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

DR. FORREST KING M.D.

Emergency Medicine