| First Coast Tms, Pllc | |
|
8825 Perimeter Park Blvd Ste 402 Jacksonville FL 32216-1124 | |
| (904) 647-6238 | |
| (904) 490-9035 |
| Full Name | First Coast Tms, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8825 Perimeter Park Blvd Ste 402, Jacksonville, Florida |
| Authorized Official Name and Position | Christopher D Gammarano (OWNER) |
| Authorized Official Contact | 9046476238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Coast Tms, Pllc Po Box 17726 Jacksonville FL 32245-7726 Ph: (904) 647-6238 | First Coast Tms, Pllc 8825 Perimeter Park Blvd Ste 402 Jacksonville FL 32216-1124 Ph: (904) 647-6238 |
| NPI Number | 1265168090 |
|---|---|
| Provider Enumeration Date | 07/25/2022 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Medicare PECOS PAC ID | 4981071651 |
|---|---|
| Medicare Enrollment ID | O20221109001975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265168090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Chadd K Eaglin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750599833 PECOS PAC ID: 9032381181 Enrollment ID: I20160225002528 |
| Provider Name | Carmela Gonzales |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699904623 PECOS PAC ID: 4385864198 Enrollment ID: I20220228000478 |
| Provider Name | Christopher Gammarano |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992294938 PECOS PAC ID: 7113275900 Enrollment ID: I20221109001963 |
| Provider Name | Jennifer Callie Maynor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194571158 PECOS PAC ID: 5294273082 Enrollment ID: I20240812001628 |
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