Individual
DR. SUNEEL KHETARPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP SURGERY TRAUMA, JACKSONVILLE, FL 32209-6511
(904) 244-6631
(904) 244-4687
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME94132
FL
2086S0102X
Surgical Critical Care Physician
Primary
ME94132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2735393-00
—
FL
01
—
P00242458
RAILROAD MEDICARE
FL
Enumeration date
02/19/2006
Last updated
09/03/2007
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