Ettedgui, Jose Alberto

Ettedgui, Jose Alberto is an individual health care provider with primary practice located at 841 Prudential Dr Ste 280 , Jacksonville FL 32207-8350. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Cardiology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Cardiology is his primary health care specialty. Ettedgui, Jose Alberto can be contacted via phone (904) 202-8550.

Contact Information

Primary practice address
841 Prudential Dr Ste 280 Jacksonville FL 32207-8350
Phone: (904) 202-8550
Fax: (904) 393-7808
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X ME86378 Florida
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME86378 Florida

Profile Details

NPI number 1316915663
LBN Legal business name Ettedgui, Jose Alberto
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2006
Last updated May 11th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316915663 NPPES
Florida MEDICAID 2637286-00
Florida MEDICAID 000723269A

Popular Providers