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NPI Code Detail

MEDICARE: DR. PENG HUANG PHD, RN, CCRN

MEDICARE: DR. PENG HUANG PHD, RN, CCRN
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
1163WC0200XCritical Care Medicine Registered NurseRN9494948FL

General Provider Information

NPI Number : 1932059615
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PENG HUANG PHD, RN, CCRN
Provider Business Mailing Address
First Line : 4500 SAN PABLO RD S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-1865
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4500 SAN PABLO RD S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-1865
Country : US
Telephone Number : 904-956-0480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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