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7546-1 103rd St Jacksonville FL 32210 | |
| (407) 798-8800 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 7546-1 103rd St, Jacksonville, Florida |
| Authorized Official Name and Position | Rebecca Rager (DIRECTOR REVENUE CYCLE) |
| Authorized Official Contact | 8449690686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4650 Westway Park Blvd Ste 206 Houston TX 77041-2006 Ph: () - | 7546-1 103rd St Jacksonville FL 32210 Ph: (407) 798-8800 |
| NPI Number | 1164160297 |
|---|---|
| Provider Enumeration Date | 05/27/2022 |
| Last Update Date | 01/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164160297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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