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NPI Code Detail

MEDICARE: CHELSEA BUGG PA-C

MEDICARE: CHELSEA BUGG PA-C
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
1363AM0700XMedical Physician AssistantPA9110215FL

Other Identifiers

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

General Provider Information

NPI Number : 1790225522
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA BUGG PA-C
Provider Business Mailing Address
First Line : 10010 LAKE SKINNER DRIVE
Second Line : APT 933
City : JACKSONVILLE
State : FL
Zip : 32246
Country : US
Telephone Number : 561-339-1004
Fax Number :
Provider Business Practice Location Address
First Line : 7207 GOLDEN WINGS RD STE 100
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-3324
Country : US
Telephone Number : 904-389-1010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2017
Last Update Date : 09/10/2018

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Directions to “ CHELSEA BUGG PA-C” Practice Location

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