JACKSONVILLE LUNG CLINIC LLC (NPI# 1861991937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861991937 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE LUNG CLINIC LLC |
| Practice Address |
7500 Rialto Blvd Ste 1-140 Austin TX 78735 |
| Mailing Address |
2624 Atlantic Blvd Ste 6 Jacksonville FL 32207-3633 |
| Practice Telephone | 5127303060 |
| Practice Fax Number | 8887301925 |
| Mailing Telephone | 9045133240 |
| Mailing Fax Number | 9042533098 |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2019-07-16 |
| Authorized Official Name | DR. JUAN DANIEL PULIDO (PRESIDENT) |
| Authorized Official Telephone | 5127303056 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 022274400 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1350 13th Ave S, Jacksonville Beach, FL 322503203 | 9046272900 | 9042533098 |
| Street Address |
7500 RIALTO BLVD STE 1-140 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194711515 | Julia Helena Cosma | Family Medicine | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2005-09-21 |
| 1538729744 | Hni Physician Services of Texas, Inc | Physician Assistant | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2019-06-19 |
| 1124688338 | Hni Medical Services of Tennessee, Pllc | Family Medicine | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2019-06-19 |
| 1194385302 | Hni Hospital Services of Ohio, LLC | Family Medicine | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2019-06-19 |
| 1265092498 | Hni Hospital Services of Louisiana, LLC | Family Medicine | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2019-06-19 |
| 1063072296 | Hni Medical Services of Indiana, PC | Family Medicine | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2019-06-19 |
| 1295395499 | Sundance Medical Services, Inc | Family Medicine | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2019-06-19 |
| 1245890441 | Hni Hospital Services of Tennessee, Pllc | Physician Assistant | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2019-06-19 |
| 1124590047 | Sherekia Lajuan Hales | Nurse Practitioner | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2018-12-18 |
| 1326490889 | Sundance Physician Services, Inc | Emergency Medicine | 7500 Rialto Blvd Ste 1-140, Austin, TX 78735-8534 | 2016-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959748 | Si Shou Acupuncture and Wellness, Pllc | Acupuncturist | 5424 W Us Hwy 290 Service Rd, Ste #106, Austin, TX 78735 | 2020-07-10 |
| 1982221115 | Andrea Fackler | Counselor | 4425 S. Mopac Expressway, Building 3, Suite 503, Austin, TX 78735 | 2020-07-03 |
| 1134763162 | Amanda Enzbigilis | Physical Therapist | 5251 W Us Highway 290, Austin, TX 78735 | 2019-11-02 |
| 1427616408 | Soco Psychotherapy, Inc | Counselor | 4425 Mopac Expressway South, Bldg II, Suite 204, Austin, TX 78735 | 2019-06-04 |
| 1306306154 | Kelly Bolerjack | Doula | 4400 Twisted Tree Drive, Austin, TX 78735 | 2019-03-20 |
| 1407362619 | Sara Katherine Paules | Counselor | 4425 South Mopac Expy, Suite 502, Austin, TX 78735 | 2017-12-26 |
| 1851806418 | Circle Medical Care of Texas P. A. | Internal Medicine | 5424 W. Us Hwy 290, 101, Austin, TX 78735 | 2017-12-05 |
| 1699293266 | Derek Kalvin Vo | Dentist | 7612 W Highway 71 Ste B, Austin, TX 78735 | 2017-09-05 |
| 1588189013 | Rachel Caroline Boraten | Audiologist | 5625 Eiger Rd Ste 125, Austin, TX 78735 | 2017-08-05 |
| 1669908489 | Lesley Caldwell Ma Lpc Pllc | Counselor | 4425 South Mopac Expy., Building IIi, Suite 603, Austin, TX 78735 | 2017-05-11 |
| Find all providers in zip 78735 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| 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 |
|---|---|---|---|---|
| 1013094515 | James Andrew Driscoll | Internal Medicine | 1305 W 34th St Ste 400, Austin, TX 78705-1922 | 2006-11-01 |
| 1801974423 | Sireesha Gogineni | Internal Medicine | 5920 W William Cannon Dr Ste 110, Austin, TX 78749-1902 | 2006-11-01 |
| 1801810080 | Jon L Belsher | Internal Medicine | 1250 S. Capital of Texas Hwy, Suite 500, Austin, TX 78746 | 2006-07-27 |
| 1184628828 | Sean C Gilbey | Internal Medicine | 5920 W William Cannon Dr, Bldg 1 Ste 150, Austin, TX 78749-1902 | 2005-06-10 |
| 1225031669 | Harold D Cain | Internal Medicine | 3600 W Parmer Ln, Ste 106, Austin, TX 78727-4107 | 2005-05-31 |
| 1477115830 | Abc Sleep Pllc | Internal Medicine | 5920 W William Cannon Dr Ste 110, Austin, TX 78749-1902 | 2019-07-05 |
| 1316193907 | Koonj Ashvin Shah | Internal Medicine | 1305 W 34th St, Suite 400, Austin, TX 78705-1923 | 2008-08-14 |
| 1427226224 | Shailaja Janaki Hayden | Internal Medicine | 1305 W 34th St, Suite 400, Austin, TX 78705-1923 | 2008-02-14 |
| 1447435805 | Austin Critical Care Specialists Pa | Internal Medicine | 11113 Research Blvd, Austin, TX 78759-5236 | 2008-01-04 |
| 1891893186 | Thaw Sint | Internal Medicine | 3600 W Parmer Ln, Ste 106, Austin, TX 78727-4107 | 2006-09-20 |
| Find all providers in AUSTIN | ||||
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| 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.