Individual
DR. CHONGLUN XIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5757 BOOTH RD, SUITE 200, JACKSONVILLE, FL 32207-5980
(904) 636-9510
(904) 636-9512
Mailing address
5757 BOOTH RD, SUITE 200, JACKSONVILLE, FL 32207-5980
(904) 636-9510
(904) 636-9512
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME92689
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16175
BCBS
FL
01
—
2574641
UNITED HEALTH CARE
—
05
—
27393819
—
FL
01
—
7245685
AETNA
FL
Enumeration date
04/18/2006
Last updated
09/21/2018
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