Basic Information
Provider Information
NPI: 1659351401
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WU
FirstName: FLORIANE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4500 SAN PABLO RD S
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322241865
CountryCode: US
TelephoneNumber: 9049532000
FaxNumber:  
Practice Location
Address1: 4201 BELFORT RD
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322161431
CountryCode: US
TelephoneNumber: 9042963700
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/18/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XME64863FLY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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