| Northeast Florida State Hospital | |
|
7487 S State Road 121 Macclenny FL 32063-5451 | |
| (904) 259-6211 | |
| (904) 259-7104 |
| Full Name | Northeast Florida State Hospital |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 7487 S State Road 121, Macclenny, Florida |
| Authorized Official Name and Position | Olga Ines Arias (SENIOR PHYSICIAN) |
| Authorized Official Contact | 9042596211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Florida State Hospital 7487 S State Road 121 Macclenny FL 32063-5451 Ph: (904) 259-6211 | Northeast Florida State Hospital 7487 S State Road 121 Macclenny FL 32063-5451 Ph: (904) 259-6211 |
| NPI Number | 1932202322 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932202322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | OS 7547 (Florida) | Primary |
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