Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lighthouse Internal Medicine and Primary Care PA

Organization Internal Medicine Physician · NPI 1588742977

Lighthouse Internal Medicine and Primary Care PA is an Internal Medicine Physician in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5757 Booth Rd #200
Jacksonville, FL 32207
Phone: (904) 636-9510
Fax: (904) 636-9512
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence ME92689 (FL)

Record details

NPI number1588742977
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chonglun Xie — Md · (904) 636-9510
NPI enumeratedNovember 1, 2006
Last updated in NPPESSeptember 21, 2018
Mailing address5757 Booth Rd Bldg 200, Jacksonville, FL 32207-5981

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