| Jacksonville Ms And Neurology Center, P.a. | |
|
1895 Kingsley Ave Ste 903 Orange Park FL 32073-4410 | |
| (904) 276-1663 | |
| (904) 276-2469 |
| Full Name | Jacksonville Ms And Neurology Center, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1895 Kingsley Ave Ste 903, Orange Park, Florida |
| Authorized Official Name and Position | Victor A Maquera (PRESIDENT) |
| Authorized Official Contact | 9042761663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacksonville Ms And Neurology Center, P.a. Po Box 17809 Jacksonville FL 32245-7809 Ph: (904) 723-5665 | Jacksonville Ms And Neurology Center, P.a. 1895 Kingsley Ave Ste 903 Orange Park FL 32073-4410 Ph: (904) 276-1663 |
| NPI Number | 1922335389 |
|---|---|
| Provider Enumeration Date | 11/05/2009 |
| Last Update Date | 01/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922335389 | NPI | - | NPPES |
| 28344 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME59449 (Florida) | Primary |
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