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5600 Spring Park Rd Suite 101 Jacksonville FL 32216-5988 | |
| (904) 737-5000 | |
| (904) 737-5008 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 5600 Spring Park Rd, Jacksonville, Florida |
| Authorized Official Name and Position | Bruce Jarvie (VP, TREASURER) |
| Authorized Official Contact | 2143793300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1720 Lakepointe Dr Ste 117 Lewisville TX 75057-6425 Ph: (214) 379-3300 | 5600 Spring Park Rd Suite 101 Jacksonville FL 32216-5988 Ph: (904) 737-5000 |
| NPI Number | 1326434390 |
|---|---|
| Provider Enumeration Date | 04/07/2015 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 0345600326 |
|---|---|
| Medicare Enrollment ID | O20230721003378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326434390 | NPI | - | NPPES |
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