| St Johns Medical Center Pa | |
|
2511 St. Johns Bluff Rd. So., Jacksonville, FL 32246 | |
| (904) 645-7559 | |
| (904) 241-0255 |
| Full Name | St Johns Medical Center Pa |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 2511 St. Johns Bluff Rd. So., Jacksonville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639284920 | NPI | - | NPPES |
| 382083100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH7497 (Florida) | Primary |
| Provider Name | Stephen Shane Alexander |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134234412 PECOS PAC ID: 3274535521 Enrollment ID: I20070215000378 |
| Provider Name | Beethoven T Ruedas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346247418 PECOS PAC ID: 6305938176 Enrollment ID: I20070824000144 |
| Mailing Address | Practice Location Address |
|---|---|
| St Johns Medical Center Pa 2511 St. Johns Bluff Rd. So., Jacksonville, FL 32246 Ph: (904) 645-7559 | St Johns Medical Center Pa 2511 St. Johns Bluff Rd. So., Jacksonville, FL 32246 Ph: (904) 645-7559 |
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