| Mc Medical Llc | |
|
4250 Philips Hwy Unit 100 Jacksonville FL 32207-6730 | |
| (904) 916-0578 | |
| Not Available |
| Full Name | Mc Medical Llc |
|---|---|
| Speciality | General Practice |
| Location | 4250 Philips Hwy Unit 100, Jacksonville, Florida |
| Authorized Official Name and Position | Soujanya Pulluru (OWNER) |
| Authorized Official Contact | 6305454046 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mc Medical Llc 702 Sw 8th St # Ms 0445 Bentonville AR 72716-0445 Ph: (479) 258-2080 | Mc Medical Llc 4250 Philips Hwy Unit 100 Jacksonville FL 32207-6730 Ph: (904) 916-0578 |
| NPI Number | 1821708975 |
|---|---|
| Provider Enumeration Date | 11/30/2022 |
| Last Update Date | 11/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821708975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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