| Cantrell Medical Clinic | |
|
1370 13th Ave S Suite 216a Jacksonville Beach FL 32250-3230 | |
| (904) 372-0208 | |
| (904) 853-6559 |
| Full Name | Cantrell Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1370 13th Ave S, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Ammala Cantrell (PRESIDENT) |
| Authorized Official Contact | 9046735553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cantrell Medical Clinic Po Box 50670 Jacksonville Beach FL 32240-0670 Ph: (904) 372-0208 | Cantrell Medical Clinic 1370 13th Ave S Suite 216a Jacksonville Beach FL 32250-3230 Ph: (904) 372-0208 |
| NPI Number | 1699955617 |
|---|---|
| Provider Enumeration Date | 11/07/2007 |
| Last Update Date | 10/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699955617 | NPI | - | NPPES |
| K8204 | Other | FL | BC/BS OF FLORIDA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME84833 (Florida) | Primary |
Jorge A Aguilar Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Beach Blvd, Jacksonville Beach, FL 32250 Phone: 904-241-8300 Fax: 904-241-0831 | |
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