Provider Demographics
NPI:1699762641
Name:ADUEN, JAVIER FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:FRANCISCO
Last Name:ADUEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 860305
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-0305
Mailing Address - Country:US
Mailing Address - Phone:904-824-8666
Mailing Address - Fax:904-824-8933
Practice Address - Street 1:300 HEALTH PARK BLVD
Practice Address - Street 2:STE 4000
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3707
Practice Address - Country:US
Practice Address - Phone:904-824-8666
Practice Address - Fax:904-824-8933
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77287207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268581700Medicaid
FL44910OtherBLUECROSS/BLUESHIELD
FLPOO846212OtherRR MEDICARE
FL44910OtherBLUECROSS/BLUESHIELD
FL268581700Medicaid