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Individual

ROMAN CRIOLLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
1680 DUNN AVE, JACKSONVILLE, FL 32218-4782
(904) 760-4904
Mailing address
1680 DUNN AVE UNIT 35-37, JACKSONVILLE, FL 32218-4782
(904) 760-4904

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
38184
AZ
208000000X
Pediatrics Physician
Primary
ME137455
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101870300
FL
05
118398900
FL
Enumeration date
12/07/2006
Last updated
11/11/2023
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