| Fountain Family Medicine, Pa | |
|
11701-32 San Jose Boulevard Suite 103 Jacksonville FL 32223 | |
| (904) 262-9075 | |
| Not Available |
| Full Name | Fountain Family Medicine, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 11701-32 San Jose Boulevard, Jacksonville, Florida |
| Authorized Official Name and Position | Leanne Macdonald (OFFICE MANAGER) |
| Authorized Official Contact | 9042629075 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Family Medicine, Pa 11701-32 San Jose Suite 103 Jacksonville FL 32223 Ph: (904) 262-9075 | Fountain Family Medicine, Pa 11701-32 San Jose Boulevard Suite 103 Jacksonville FL 32223 Ph: (904) 262-9075 |
| NPI Number | 1124228119 |
|---|---|
| Provider Enumeration Date | 07/19/2007 |
| Last Update Date | 08/28/2012 |
| Medicare PECOS PAC ID | 9537184114 |
|---|---|
| Medicare Enrollment ID | O20051012000968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124228119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Boyd Daniel Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790760296 PECOS PAC ID: 1254356835 Enrollment ID: I20051013000203 |
| Provider Name | Rafael A Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801068135 PECOS PAC ID: 7517155377 Enrollment ID: I20101220001139 |
| Provider Name | Dana M Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134421399 PECOS PAC ID: 8224293238 Enrollment ID: I20120625000663 |
| Provider Name | Kerri C Jarrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013349604 PECOS PAC ID: 6204070774 Enrollment ID: I20130924000134 |
Lem Turner Family Medical Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9390 Lem Turner Rd, Jacksonville, FL 32208 Phone: 904-766-2953 Fax: 904-766-2993 | |
C. Surgery Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 532 Riverside Ave, Jacksonville, FL 32202 Phone: 904-791-6632 | |
Centerwell Senior Primary Care Fl Jv Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4250 Philips Hwy, Jacksonville, FL 32207 Phone: 407-447-7120 | |
Id Associates Of Jacksonville Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Shircliff Way, Ste 610, Jacksonville, FL 32204 Phone: 904-387-5027 Fax: 904-387-2208 | |
Hong Tek Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4123 University Blvd S, Jacksonville, FL 32216 Phone: 904-388-3351 | |
Baptist Primary Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 532 Riverside Ave Ste 103, Jacksonville, FL 32202 Phone: 904-353-5696 Fax: 904-390-7483 | |
Reginald L. Sykes, Sr, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3160 Edgewood Ave W, Jacksonville, FL 32209 Phone: 904-768-8222 Fax: 904-482-0373 |