Individual
DR. ELISE MICHELLE FALLUCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
580 W 8TH ST, JACKSONVILLE, FL 32209-6533
(904) 383-1038
(904) 244-3425
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 383-1038
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME109877
FL
2084P0804X
Child & Adolescent Psychiatry Physician
2008007446
MO
2084P0804X
Child & Adolescent Psychiatry Physician
ME109877
FL
Other
Enumeration date
10/04/2006
Last updated
08/18/2017
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