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Emilio P Supsupin JR., MD
Neuroradiology Physician in Jacksonville, Florida
NPI 1225069800

Emilio P Supsupin JR. is a Neuroradiology Physician based in Jacksonville, FL and is specialized in Neuroradiology. Emilio P Supsupin JR. practices in Jacksonville, FL and has the professional credentials of MD. The NPI Number for Emilio P Supsupin JR. is 1225069800 and holds a License No. N5422 (Florida).

The current practice location address for Emilio P Supsupin JR. is 655 W 8Th St, Jacksonville, FL and can be reached out via phone at 904-244-4202.

Location: 655 W 8Th St, Jacksonville, FL, 32231-4008
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225069800
Provider Name
Emilio P Supsupin JR.
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
655 W 8Th St, Jacksonville, FL, 32231-4008
Phone Number
904-244-4202
Fax Number
Provider Enumeration Date
07/05/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
182077101 05 TX
8S7138 01 TX BCBSTX
182077102 01 TX CSHCN
institution
Provider Business Practice Location Address Details
Address
655 W 8Th St
City
Jacksonville
State
Florida
Zip
32209-6511
Phone Number
904-244-4202
Fax Number
person
Provider Business Mailing Address Details
Address
655 W 8Th St
City
Jacksonville
State
Florida
Zip
32209-6511
Phone Number
904-244-4202
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Neuroradiology
Taxonomy
2085N0700X
License No.
N5422 (Texas)
Definition
A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
N5422 (Texas)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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