Individual
DR. DANIEL JOSE VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4205 BELFORT RD STE 3075, JACKSONVILLE, FL 32216-1475
(904) 450-8140
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS17678
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/09/2018
Last updated
07/21/2021
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