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

Table of Contents

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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