1932117363 NPI number — DR. PAUL J CONE O. D.

Table of content: DR. PAUL J CONE O. D. (NPI 1932117363)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932117363 NPI number — DR. PAUL J CONE O. D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CONE
Provider First Name:
PAUL
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O. D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932117363
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
961 CESERY BLVD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32211-5607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-743-1311
Provider Business Mailing Address Fax Number:
904-743-2802

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
961 CESERY BLVD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32211-5607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-743-1311
Provider Business Practice Location Address Fax Number:
904-743-2802
Provider Enumeration Date:
08/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OPC 912 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 275141 . This is a "WELLCARE MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 593674223 . This is a "TRICARE SOUTH REGION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1327 . This is a "ICARE HEALTH SOLUTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 084457800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: PV00000103078 . This is a "ADVANTICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0003780741 . This is a "PREMIER EYE CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: FL3973 . This is a "EYEMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007832827 . This is a "APWU HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 07GRB . This is a "FLORIDA BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 410046556 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 66703 . This is a "DAVIS VISION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P01185759 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12770 . This is a "OPTUMHEALTH VISION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 003007293 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0318948 . This is a "WELLMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 041327 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 19510 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 410046556 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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