Healthcare Provider Details

I. General information

NPI: 1710683057
Provider Name (Legal Business Name): JULIAN FRANCISCO SIFRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 KINGSLEY AVE
ORANGE PARK FL
32073-5148
US

IV. Provider business mailing address

200 RIVERSIDE AVE UNIT 709
JACKSONVILLE FL
32202-4990
US

V. Phone/Fax

Practice location:
  • Phone: 904-639-8500
  • Fax:
Mailing address:
  • Phone: 787-508-6153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number43734
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: