Organization
JACKSONVILLE LUNG CLINIC PLLC
Active
Organization
JACKSONVILLE LUNG CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN DANIEL PULIDO MD (PRESIDENT/OWNER)
(904) 513-3240
Entity
Organization
Contact information
Practice address
2624 ATLANTIC BLVD STE 6, JACKSONVILLE, FL 32207-3633
(904) 513-3240
(904) 253-3098
Mailing address
2624 ATLANTIC BLVD STE 6, JACKSONVILLE, FL 32207-3633
(904) 513-3240
(904) 398-7871
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
—
02227440
—
FL
Enumeration date
01/08/2018
Last updated
03/28/2018
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