Individual
DR. JOSE C YATACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 SHIRCLIFF WAY BLDG STE 435, JACKSONVILLE, FL 32204-4753
(904) 308-6900
(904) 308-6927
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6063
(904) 450-6401
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
40977
TN
207RP1001X
Pulmonary Disease Physician
Primary
ME91430
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004504000
—
FL
Enumeration date
05/09/2006
Last updated
12/23/2020
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