Organization
SIVANTA J PAUL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIVANTA J PAUL M.D. (PRESIDENT)
(904) 279-1666
Entity
Organization
Contact information
Practice address
4237 SALISBURY RD, STE 301, JACKSONVILLE, FL 32216-8029
(904) 279-1666
(904) 279-1665
Mailing address
PO BOX 19949, JACKSONVILLE, FL 32245-0949
(904) 279-1666
(904) 279-1665
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME56495
FL
Other
Enumeration date
05/30/2006
Last updated
03/09/2020
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