| Oceanway Medical Center, Inc. | |
|
11513 N Main St Jacksonville FL 32218-4002 | |
| (904) 751-6200 | |
| (904) 751-1600 |
| Full Name | Oceanway Medical Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 11513 N Main St, Jacksonville, Florida |
| Authorized Official Name and Position | Jeanne Micolucci (PRESIDENT) |
| Authorized Official Contact | 9047516200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oceanway Medical Center, Inc. 11513 N Main St Jacksonville FL 32218-4002 Ph: (904) 751-6200 | Oceanway Medical Center, Inc. 11513 N Main St Jacksonville FL 32218-4002 Ph: (904) 751-6200 |
| NPI Number | 1245255199 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245255199 | NPI | - | NPPES |
| 257848400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Florida) | Primary |
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