Bucolo, Paul

Bucolo, Paul is an individual health care provider with primary practice located at 125 Florida Memorial Pkwy Ste 2200 , New Smyrna Beach FL 32168-9309. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Bucolo, Paul can be contacted via phone (386) 409-6839.

Contact Information

Primary practice address
125 Florida Memorial Pkwy Ste 2200 New Smyrna Beach FL 32168-9309
Phone: (386) 409-6839
Fax: (386) 409-6916
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 3476 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X PA3476 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME143433 Florida

Profile Details

NPI number 1871633719
LBN Legal business name Bucolo, Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2007
Last updated Apr 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871633719 NPPES
Florida MEDICAID 290408000

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