Individual
DR. DMITRIY MODEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1633 RACE TRACK RD, SUITE 1, JACKSONVILLE, FL 32259-4222
(904) 230-6988
(904) 342-4028
Mailing address
1633 RACE TRACK RD, SUITE 1, JACKSONVILLE, FL 32259
(904) 230-6988
(904) 342-4028
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME88320
FL
Other
Enumeration date
05/04/2006
Last updated
07/08/2007
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