| Elite Hospitalist Group | |
|
4201 Belfort Rd Jacksonville FL 32216-1431 | |
| (904) 758-8020 | |
| Not Available |
| Full Name | Elite Hospitalist Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 4201 Belfort Rd, Jacksonville, Florida |
| Authorized Official Name and Position | Kelvin James Wiley (PRESIDENT) |
| Authorized Official Contact | 9047588020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Hospitalist Group 1650 Margaret St Ste 302 Jacksonville FL 32204-3869 Ph: (904) 758-8020 | Elite Hospitalist Group 4201 Belfort Rd Jacksonville FL 32216-1431 Ph: (904) 758-8020 |
| NPI Number | 1689063406 |
|---|---|
| Provider Enumeration Date | 01/16/2015 |
| Last Update Date | 04/26/2016 |
| Medicare PECOS PAC ID | 7214245984 |
|---|---|
| Medicare Enrollment ID | O20150929002355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689063406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME 0111390 (Florida) | Primary |
| Provider Name | Kelvin James Wiley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194810481 PECOS PAC ID: 3971604638 Enrollment ID: I20121011000564 |
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