Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Alan Ekanem, MD

Individual provider General Practice Physician · NPI 1104272335

Dr. Alan Ekanem, MD is a General Practice in Jacksonville, Florida. Qualified in 1998, 28 years ago. Practices with Conviva Medical Center Management, LLC, a 562-clinician group and accepts Medicare assignment. Licensed in Florida and Puerto Rico.

Years since qualifying
28
Licensed in
FL, PR
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1028 Dunn Ave
Jacksonville, FL 32218-4830
Phone: (904) 766-7606
Fax: (904) 766-7679
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence ACN891 (FL)
General Practice Physician Taxonomy 208D00000X · Licence 19424 (PR)

Record details

NPI number1104272335
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 6, 2016
Last updated in NPPESFebruary 12, 2026
Certification dateFebruary 12, 2026
Mailing address6101 Blue Lagoon Dr Ste 400, Miami, FL 33126-2051

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Conviva Medical Center Management, Llc — 562 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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