Healthcare Provider Details

I. General information

NPI: 1699762641
Provider Name (Legal Business Name): JAVIER FRANCISCO ADUEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD STE 4000
ST AUGUSTINE FL
32086-3707
US

IV. Provider business mailing address

PO BOX 860305
ST AUGUSTINE FL
32086-0305
US

V. Phone/Fax

Practice location:
  • Phone: 904-824-8666
  • Fax: 904-824-8933
Mailing address:
  • Phone: 904-824-8666
  • Fax: 904-824-8933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME77287
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME77287
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: