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

Mira M Lotfalla, MBBCH

Individual provider Anatomic Pathology Physician · NPI 1164956611

Mira M Lotfalla, MBBCH is a Pathology in Jacksonville, Florida. Qualified in 2008, 18 years ago. Practices with Mayo Clinic Jacksonville, a 1,581-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida, Maryland and Minnesota.

Years since qualifying
18
Licensed in
FL, MD, MN
In the registry since
2017
Specialties on file
4
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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12902 Usf Magnolia Dr, Tampa, FL 33612-9416 — (813) 745-4673

Specialties & licences

Anatomic Pathology Physician (primary) Taxonomy 207ZP0101X · Licence ME156755 (FL)
Anatomic Pathology Physician Taxonomy 207ZP0101X · Licence 28405 (MN)
Anatomic Pathology Physician Taxonomy 207ZP0101X · Licence 65883 (MN)
Anatomic Pathology Physician Taxonomy 207ZP0101X · Licence D89548 (MD)

Record details

NPI number1164956611
Entity typeIndividual (Type 1)
GenderFemale
Credentials MBBCH
Sole proprietorNo
NPI enumeratedApril 11, 2017
Last updated in NPPESMay 29, 2024
Certification dateMay 29, 2024

Medicare enrollment

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

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Mayo Clinic Jacksonville — 1581 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Jacksonville