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General NPI Number Information
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NPI Number | 1912219064
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Entity Type | Organization
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Legal Business Name | EMED URGENT AND PRIMARY CARE INC
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 2624 ATLANTIC BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3609
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Country | US
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Telephone | 904-513-3240
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Fax | 904-379-2911
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Provider Business Mailing Address
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Address Line | 2624 ATLANTIC BOULEVARD
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City | JACKSONVILLE
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State | FL
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Zip | 32207
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Country | US
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Telephone | 904-513-3240
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Fax | 904-379-2911
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. RENE U PULIDO
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Credential | M.D.
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Telephone | 904-513-3240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 10D2009297
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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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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