Organization
CISCA PULMONARY CRITICAL CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS AUGUSTINE VAZQUEZ DO (PHYSICIAN OWNER)
(904) 419-3986
Entity
Organization
Contact information
Practice address
1361 13TH AVE S STE 245, JACKSONVILLE BEACH, FL 32250
(904) 493-7174
(904) 694-0696
Mailing address
1361 13TH AVE S STE 245, JACKSONVILLE BEACH, FL 32250-3238
(904) 396-0300
(904) 396-3039
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009836500
—
FL
05
—
2757133-00
—
FL
Enumeration date
08/29/2012
Last updated
05/21/2025
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