Organization
JOSE A DE JESUS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE A. DE JESUS-CARBUCCIA MD (PRESIDENT)
(561) 236-7741
Entity
Organization
Contact information
Practice address
1620 S CONGRESS AVE, SUITE 100, PALM SPRINGS, FL 33461-2128
(850) 561-2032
(561) 968-1046
Mailing address
PO BOX 9668, PENSACOLA, FL 32513-9668
(850) 478-1312
(850) 474-9060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008LM
FLORIDA BLUE
FL
Enumeration date
12/24/2014
Last updated
02/25/2015
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