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NPI Code Detail

MEDICARE: DR. JEFFREY DIMASCIO DO

MEDICARE:  DR. JEFFREY  DIMASCIO  DO
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
1207RH0003XHematology & Oncology PhysicianOS 9460FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116028AOTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3299129OTHERFLAVMED
47799487OTHERFLAETNA

General Provider Information

NPI Number : 1679578595
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY DIMASCIO DO
Provider Business Mailing Address
First Line : 7015 AC SKINNER PARKWAY
Second Line : SUITE 1
City : JACKSONVILLE
State : FL
Zip : 32256
Country : US
Telephone Number : 904-363-2113
Fax Number : 904-363-2606
Provider Business Practice Location Address
First Line : 14546 OLD SAINT AUGUSTINE RD
Second Line : BLDG A SUITE 317
City : JACKSONVILLE
State : FL
Zip : 32258-5468
Country : US
Telephone Number : 904-739-7779
Fax Number : 904-739-7771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 06/06/2013

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Directions to “ DR. JEFFREY DIMASCIO DO” Practice Location

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