Individual
BIAGIO V VULTAGGIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10010 BELLE RIVE BLVD, #1211, JACKSONVILLE, FL 32256-9056
(904) 254-2459
Mailing address
10010 BELLE RIVE BLVD, #1211, JACKSONVILLE, FL 32256-9056
(904) 254-2459
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME96271
FL
207R00000X
Internal Medicine Physician
TP706
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276646900
—
FL
01
—
56679
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/28/2006
Last updated
09/24/2020
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