Florida Center For Infectious Diseases, INC.
Specialist in Jacksonville, FL. Organization (NPI-2).
NPI number1316217896
StatusActive
Last updated in NPPESFeb 16, 2012
Details
- NPI
- 1316217896
- Entity type
- Organization (NPI-2)
- Legal business name
- Florida Center For Infectious Diseases, INC.
- Organization subpart
- No
- Enumeration date
- Dec 30, 2011
- Last updated
- Feb 16, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | ME96311 | FL | Yes |
Practice location
14810 Old Saint Augustine RdSuite 201
Jacksonville, FL 32258-2451
Phone 904-292-0863 · Fax 904-212-0884
Mailing address
5055 Monroe Forest DrJacksonville, FL 32257-2204
Authorized official
Desiree D Clark
President
9043221140
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