Physical Healthcare Of Jacksonville INC
Internal Medicine in Jacksonville, FL. Organization (NPI-2).
NPI number1760722011
StatusActive
Last updated in NPPESApr 18, 2017
Details
- NPI
- 1760722011
- Entity type
- Organization (NPI-2)
- Legal business name
- Physical Healthcare Of Jacksonville INC
- Organization subpart
- No
- Enumeration date
- Feb 25, 2013
- Last updated
- Apr 18, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | ME55161 | FL | Yes |
| 111N00000X | Chiropractor | CH6451 | FL | |
| 111N00000X | Chiropractor | CH6588 | FL | |
| 111N00000X | Chiropractor | CH4435 | FL | |
| 208100000X | Physical Medicine & Rehabilitation | ME0060908 | FL | |
| 225100000X | Physical Therapist | PT30658 | FL | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | ME55161 | FL | |
| 363AM0700X | Physician Assistant, Medical | PA9106788 | FL | |
| 363LF0000X | Nurse Practitioner, Family | ARNP 770742 | FL | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | ME0060908 | FL |
Practice location
12620 Beach BlvdSuite 6
Jacksonville, FL 32246-7131
Phone 904-645-0777 · Fax 904-645-3483
Mailing address
12620 Beach BlvdSuite 6
Jacksonville, FL 32246-7131
Phone 904-645-0777 · Fax 904-645-3483
Authorized official
Mark A Pierce
Clinic Director
9046450777
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