| Jax Psychiatry Llc | |
|
145 Hilden Rd Ste 108 Ponte Vedra FL 32081-8401 | |
| (904) 834-1242 | |
| Not Available |
| Full Name | Jax Psychiatry Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 145 Hilden Rd Ste 108, Ponte Vedra, Florida |
| Authorized Official Name and Position | Riaz Ahmed (M.D./ PRESIDENT) |
| Authorized Official Contact | 9048348042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jax Psychiatry Llc 145 Hilden Rd Ste 108 Ponte Vedra FL 32081-8401 Ph: (904) 834-1242 | Jax Psychiatry Llc 145 Hilden Rd Ste 108 Ponte Vedra FL 32081-8401 Ph: (904) 834-1242 |
| NPI Number | 1124538525 |
|---|---|
| Provider Enumeration Date | 10/11/2017 |
| Last Update Date | 10/12/2021 |
| Certification Date | 10/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124538525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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