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Individual

DR. JOSE DAVID PUELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6350 DAVIS BLVD # 1001, NAPLES, FL 34104-5323
(239) 658-3000
Mailing address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3064
(239) 658-3175

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME111013
FL
208000000X
Pediatrics Physician
Primary
ME111013
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004105900
FLORIDA MEDICAID
FL
01
2-1547
MEDICARE
FL
Enumeration date
02/27/2006
Last updated
04/26/2023
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