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Contact Information

GERARD A COLUCCELLI MD PA
1235 SAN MARCO BLVD
401
JACKSONVILLE, FL32207
 Phone: 904-346-3506
 Fax: 904-346-0712
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for GERARD A COLUCCELLI MD PA

NPI Number 1477605962
LBN Legal business name GERARD A COLUCCELLI MD PA
Authorized official GERARD COLUCCELLI - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/17/2007
Last updated 03/27/2008 - About 18 years ago
Identifiers
FL License # ME39542
FL Other 15671 BLUE CROSS BLUE SHIELD
FL Other K2484 MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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