Individual
DR. IOAN CORNELIU CUCORANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
559 W TWINCOURT TRL UNIT 604A, ST AUGUSTINE, FL 32095-8805
(904) 551-9949
Mailing address
7929 STRATFORD CHASE LN, JACKSONVILLE, FL 32256-3445
(904) 551-9949
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
078009
GA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
ME119404
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003147334A
—
GA
05
—
011137000
—
FL
01
—
14U8G
BCBS
FL
Enumeration date
05/16/2008
Last updated
07/03/2024
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