Organization
PULMONARY & CRITICAL CARE CONSULTANTS OF JACKSONVILLE PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMIT K CHAKRAVARTY M.D. (OWNER)
(904) 739-6666
Entity
Organization
Contact information
Practice address
8075 GATE PKWY W, SUITE 304, JACKSONVILLE, FL 32216-3684
(904) 739-6666
(904) 739-1009
Mailing address
PO BOX 551537, JACKSONVILLE, FL 32255-1537
(904) 739-6666
(904) 739-1009
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME53176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF4633
RAILROAD MEDICARE GROUP
FL
Enumeration date
10/13/2006
Last updated
09/02/2008
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