DR. JOSE ALBERTO ETTEDGUI M.D. NPI 1316915663

NPI Information

DR. Jose Alberto Ettedgui, M.D. is a pediatric cardiology pediatrics in Jacksonville, FL. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. DR. Jose Alberto Ettedgui, M.D. NPI is 1316915663. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

841 PRUDENTIAL DR STE 280
JACKSONVILLE, FL
ZIP 32207-350
Phone: (904) 202-8550
Fax: (904) 393-7808

The NPI 1316915663 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/12/2006 and was last updated on 5/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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