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Individual

PRABHAV VASISTHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MBBS

Contact information

Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME162556
FL

Other

Enumeration date
09/03/2020
Last updated
07/06/2023
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