Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | ME23103 | FL |
Y | 207RI0011X | Interventional Cardiology | ME23103 | FL |
N | 207U00000X | Nuclear Medicine Specialist | ME23103 | FL |
NPI | 1184680985 |
---|---|
Provider Name | Mr. Paul H Dillahunt II |
First Address | Jacksonville, FL 32203-3667 |
Second Address | Jacksonville, FL 32207-8204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 16/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036771100 | (05) | FL |
D61928 | (02) | FL |