| Meadowlands Medical Center,pa | |
|
179 College Dr Ste 17 Orange Park FL 32065-7705 | |
| (904) 592-7818 | |
| (904) 602-5599 |
| Full Name | Meadowlands Medical Center,pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 179 College Dr, Orange Park, Florida |
| Authorized Official Name and Position | Marc Louis Alessandria (OWNER/PRESIDENT) |
| Authorized Official Contact | 9045927818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meadowlands Medical Center,pa 179 College Dr Ste 17 Orange Park FL 32065-7705 Ph: (904) 272-7272 | Meadowlands Medical Center,pa 179 College Dr Ste 17 Orange Park FL 32065-7705 Ph: (904) 592-7818 |
| NPI Number | 1124050711 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 10/25/2017 |
| Medicare PECOS PAC ID | 6507769627 |
|---|---|
| Medicare Enrollment ID | O20040128000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124050711 | NPI | - | NPPES |
| 72398 | Other | FL | BLUE CROSS |
| 265625600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME70009 (Florida) | Primary |
| Provider Name | Marc L. Alessandria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598797169 PECOS PAC ID: 8527961655 Enrollment ID: I20110128000568 |
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