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Organization
GERARD A COLUCCELLI MD PA
Active
Organization
GERARD A COLUCCELLI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARD A COLUCCELLI M.D. (PRESIDENT)
(904) 346-3506
Entity
Organization
Contact information
Practice address
1235 SAN MARCO BLVD, 401, JACKSONVILLE, FL 32207
(904) 346-3506
(904) 346-0712
Mailing address
1235 SAN MARCO BLVD, 401, JACKSONVILLE, FL 32207
(904) 346-3506
(904) 346-0712
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME39542
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15671
BLUE CROSS BLUE SHIELD
FL
01
—
K2484
MEDICARE
FL
Enumeration date
01/17/2007
Last updated
03/27/2008
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