Individual
JOSE D CERON-FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
820 PRUDENTIAL DR STE 304, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME95797
FL
208M00000X
Hospitalist Physician
Primary
ME95797
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277524700
—
FL
Enumeration date
10/11/2006
Last updated
06/26/2024
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