Individual
COLIN ROBERT CHALOUPECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 VILLAGE OAKS DR, ST JOHNS, FL 32259-3876
(904) 240-0442
Mailing address
201 VILLAGE OAKS DR, ST JOHNS, FL 32259-3876
(904) 240-0442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
68726
TN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME167666
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
06/21/2024
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