Individual
DR. MICHAEL JAMES LUPI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11705 SAN JOSE BLVD STE 110, JACKSONVILLE, FL 32223
(904) 292-2700
(904) 292-2666
Mailing address
4730 N HABANA AVE STE 204, TAMPA, FL 33614-7148
(813) 549-2134
(813) 864-4436
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
038152
GA
208VP0014X
Interventional Pain Medicine Physician
038152
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
OS14239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000597726F
—
GA
05
—
000597726G
—
GA
01
—
P00146494
RR MEDICARE
GA
Enumeration date
02/24/2006
Last updated
05/22/2018
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