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

Individual provider Psychiatry Physician · NPI 1205071719

Dr. Imtiaz Rasul, MD is a Psychiatry in Jacksonville, Florida. Qualified in 2002, 24 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
24
Licensed in
FL
In the registry since
2008
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

10175 Fortune Pkwy Ste 206
Jacksonville, FL 32256-6746
Phone: (904) 379-8748
Fax: (904) 379-8796
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence ME-112178 (FL)

Record details

NPI number1205071719
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedDecember 12, 2008
Last updated in NPPESOctober 10, 2025
Certification dateOctober 10, 2025

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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