Provider Demographics
NPI:1023089182
Name:KARTSONIS, JOHN PAUL (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:KARTSONIS
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 1:7711 BAYMEADOWS RD E STE 6
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9110
Mailing Address - Country:US
Mailing Address - Phone:904-731-1770
Mailing Address - Fax:904-996-8300
Practice Address - Street 1:7711 BAYMEADOWS RD E STE 6
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9110
Practice Address - Country:US
Practice Address - Phone:904-731-1770
Practice Address - Fax:904-996-8300
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046965207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02754WMedicare PIN
FLD20781Medicare UPIN