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Individual

PAUL MONGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-4195
(904) 244-4908
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-3660
(904) 244-3425

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
46463
CO
207L00000X
Anesthesiology Physician
Primary
ME117165
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
73053562
CO
Enumeration date
09/24/2006
Last updated
09/26/2016
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