JACKSONVILLE LUNG CLINIC PLLC (NPI# 1710494000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710494000 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE LUNG CLINIC PLLC |
| Practice Address |
2624 Atlantic Blvd Ste 6 Jacksonville FL 32207-3633 |
| Practice Telephone | 9045133240 |
| Practice Fax Number | 9042533098 |
| Mailing Telephone | 9045133240 |
| Mailing Fax Number | 9043987871 |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-03-28 |
| Authorized Official Name | JUAN DANIEL PULIDO (PRESIDENT/OWNER) |
| Authorized Official Telephone | 9045133240 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 02227440 | 05 |
| Street Address |
2624 ATLANTIC BLVD STE 6 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-3633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376974485 | Gottskalk Bjornsson | Internal Medicine | 363 Creedmoor Rd, Jacksonville, NC 28546-6035 | 2013-11-29 |
| 1275890402 | Amit K Babbar | Internal Medicine | 1325 San Marco Blvd Ste 300, Jacksonville, FL 32207-8567 | 2012-04-12 |
| 1902178254 | Dennis J Mcdonagh M D P A | Internal Medicine | 2636 Forest Cir, Jacksonville, FL 32257-5612 | 2012-02-02 |
| 1386891042 | Leo F Black | Internal Medicine | 8244 Shady Grove Rd, Jacksonville, FL 32256-7361 | 2008-08-25 |
| 1376744581 | Margaret Davis Hovda | Internal Medicine | 425 North Lee Street, Suite 203, Jacksonville, FL 32204-1128 | 2007-05-29 |
| 1598781643 | Daniel S Wyzan | Internal Medicine | 425 North Lee St, Suite 203, Jacksonville, FL 32204-1128 | 2006-07-14 |
| 1619962230 | Bruce Mitchell Yergin | Internal Medicine | 3627 University Blvd S Ste 300, Jacksonville, FL 32216 | 2005-09-20 |
| 1649782392 | Emed Urgent and Primary Care Pa | Internal Medicine | 2624 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| 1750764668 | David Abia Trujillo | Internal Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-07-09 |
| 1326433624 | Scott Richard Steinberg | Internal Medicine | 655 W 8th St, Jacksonville, FL 32209-6511 | 2015-04-02 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on JACKSONVILLE LUNG CLINIC PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.