Organization
CISCA PULMONARY CRITICAL CARE INC
Active
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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