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Individual

PAUL D LUCEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7300
(904) 346-0113
Mailing address
PO BOX 863026, ORLANDO, FL 32886-3026
(800) 288-8325
(419) 866-5453

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0050050
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00767423A
GEORGIA MEDICAID
GA
01
03786
BCBS
FL
05
045769800
FL
01
930000749
RAILROAD MEDICARE
FL
Enumeration date
06/10/2006
Last updated
01/28/2013
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