MEDICARE: DR. MARIO ALBERTO PULIDO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	ME96518	FL
2	207R00000X	Internal Medicine Physician	ME96518	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366602336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIO ALBERTO PULIDO M.D.

Provider Business Mailing Address
First Line	:	2624 ATLANTIC BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-3668
Country	:	US
Telephone Number	:	904-513-3240
Fax Number	:	904-379-2911

Provider Business Practice Location Address
First Line	:	2624 ATLANTIC BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-3668
Country	:	US
Telephone Number	:	904-513-3240
Fax Number	:	904-379-2911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2008
Last Update Date	:	08/12/2025

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