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General NPI Number Information
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NPI Number | 1255403689
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Entity Type | Organization
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Legal Business Name | FIRST COAST PULMONARY ASSOCIATES
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3 PINE CONE DR SUITE # 106
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City | PALM COAST
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State | FL
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Zip | 32137-8685
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Country | US
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Telephone | 386-986-1422
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Fax | 386-986-1415
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Provider Business Mailing Address
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Address Line | 150 SOUTHPARK BLVD SUITE 208
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5179
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Country | US
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Telephone | 904-819-6800
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Fax | 904-819-6700
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Authorized Official
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Title or Position | PRESIDENT
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Name | BERNARD R BORBELYQ
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Credential | MD
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Telephone | 904-819-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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