Organization
CLAY PULMONARY SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA ANTONIO-MIRANDA MD (OWNER)
(904) 269-9200
Entity
Organization
Contact information
Practice address
1409 KINGSLEY AVE, BUILDING 3B, ORANGE PARK, FL 32073-4537
(904) 269-9200
(904) 269-7796
Mailing address
1409 KINGSLEY AVE, BUILDING 3B, ORANGE PARK, FL 32073-4537
(904) 269-9200
(904) 269-7796
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME74314
FL
Other
Enumeration date
04/17/2015
Last updated
04/17/2015
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