Individual
DR. PATRICK SEMAAN ANTOUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 383-1011
(904) 244-3102
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-3660
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME118156
FL
390200000X
Student in an Organized Health Care Education/Training Program
11013939A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003147062A
—
GA
05
—
011135500
—
FL
01
—
14U8D
BCBS
FL
Enumeration date
06/16/2008
Last updated
07/08/2014
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