Organization
ST. VINCENT'S INTENSIVISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL WYZAN M.D. (PRESIDENT)
(904) 354-8200
Entity
Organization
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 354-8200
(904) 354-1340
Mailing address
425 N LEE ST, SUITE 203, JACKSONVILLE, FL 32204-1127
(904) 354-8200
(904) 354-1340
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Enumeration date
01/04/2011
Last updated
01/04/2011
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