<unavail> in Orange Park, FL - Medicare Physiological Laboratory

is a medicare enrolled mental health clinic (Physiological Laboratory) in Orange Park, Florida. The current practice location for is 1895 Kingsley Ave, Suite 1005, Orange Park, Florida. For appointments, you can reach them via phone at (904) 737-5792. The mailing address for is Po Box 1450, Orange Park, Florida and phone number is (904) 737-5792.

is licensed to practice in Florida (license number HCC4403). The clinic also participates in the medicare program and its NPI number is 1427101658. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (904) 737-5792.

Contact Information


	1895 Kingsley Ave Suite 1005 Orange Park FL 32073-4466
	(904) 737-5792
	(904) 737-6541

Map and Direction

Mental Health Clinic Profile

Full Name
Speciality	Physiological Laboratory
Location	1895 Kingsley Ave, Orange Park, Florida
Authorized Official Name and Position	Aurelio A. Muzaurieta (PRESIDENT/TECHNICAL DIRECTOR)
Authorized Official Contact	9047375792
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 1450 Orange Park FL 32067-1450 Ph: (904) 737-5792	1895 Kingsley Ave Suite 1005 Orange Park FL 32073-4466 Ph: (904) 737-5792

NPI Details:

NPI Number	1427101658
Provider Enumeration Date	01/19/2007
Last Update Date	09/26/2008

Medicare PECOS Information:

Medicare PECOS PAC ID	9133245319
Medicare Enrollment ID	O20100924000643

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427101658	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084N0600X	Psychiatry & Neurology - Clinical Neurophysiology	(* (Not Available))	Secondary
231H00000X	Audiologist	(* (Not Available))	Secondary
246ZE0600X	Specialist/technologist, Other - Electroneurodiagnostic	(* (Not Available))	Secondary
2471V0105X	Radiologic Technologist - Vascular Sonography	(* (Not Available))	Secondary
293D00000X	Physiological Laboratory	HCC4403 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Travis R Von Tobel
Provider Type	Practitioner - Pain Management
Provider Identifiers	NPI Number: 1487954723 PECOS PAC ID: 3971724477 Enrollment ID: I20150617003007

Reviews and Comments

Physiological Laboratory in Orange Park, FL

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- Medicare Mental Health Clinic in Orange Park, FL