Mikulic, Mariano B

Mikulic, Mariano B is an individual health care provider with primary practice located at 1824 King Street Suite 300, Jacksonville FL 32204-4736. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Mikulic, Mariano B can be contacted via phone (904) 388-1820.

Contact Information

Primary practice address
1824 King Street Suite 300 Jacksonville FL 32204-4736
Phone: (904) 388-1820
Fax: (904) 388-1827
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME73598 Florida
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 046312 Georgia

Profile Details

NPI number 1639172836
LBN Legal business name Mikulic, Mariano B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated May 28th, 2014 - about 10 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639172836 NPPES
Georgia Other 365273 BCBS
Georgia Other 245320 BCBS
Georgia MEDICAID 00793581D BCBS
Georgia Other 42895 BCBS
Georgia MEDICAID 254507100 BCBS
Georgia Other 2049932 BCBS
Georgia MEDICAID 00793581A BCBS

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