| Neurology Associates Of North Florida , Inc | |
|
1361 13th Ave S Ste 170a Jacksonville Beach FL 32250-3235 | |
| (904) 249-4456 | |
| (904) 249-7703 |
| Full Name | Neurology Associates Of North Florida , Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1361 13th Ave S Ste 170a, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Richard Boehme (PRESIDENT) |
| Authorized Official Contact | 9042494456 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Associates Of North Florida , Inc Po Box 17809 Jacksonville FL 32245-7809 Ph: (904) 723-0015 | Neurology Associates Of North Florida , Inc 1361 13th Ave S Ste 170a Jacksonville Beach FL 32250-3235 Ph: (904) 249-4456 |
| NPI Number | 1104863042 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 01/24/2012 |
| Medicare PECOS PAC ID | 5698707123 |
|---|---|
| Medicare Enrollment ID | O20050906000957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104863042 | NPI | - | NPPES |
| DD6330 | Other | R.R. MEDICARE | |
| 33708 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME62533 (Florida) | Primary |
| Provider Name | Erin G Doty |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790866747 PECOS PAC ID: 2264497270 Enrollment ID: I20041201000203 |
| Provider Name | Richard J Boehme |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245227800 PECOS PAC ID: 4789574799 Enrollment ID: I20050907000269 |
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