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Individual

MR. BRUCE J MCINTOSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-2998
Mailing address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-2998

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0043803
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08659
HEALTHEASE
FL
01
15876
BCBS
FL
01
4008067-003
CIGNA
FL
01
4047758
AETNA
FL
Enumeration date
08/22/2005
Last updated
07/08/2007
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