Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Fatah Abdul Wallizada, MD

Individual provider Pediatrics Physician · NPI 1255351599

Dr. Fatah Abdul Wallizada, MD is a Pediatrics Physician in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2006
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

1395 Cassat Ave Suite# 1
Jacksonville, FL 32205-9616
Phone: (904) 388-5832
Fax: (904) 388-6270
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence ME0062087 (FL)

Record details

NPI number1255351599
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 20, 2006
Last updated in NPPESJuly 8, 2007

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