Organization · Type 2 NPI

Florida Department of Health

Federally Qualified Health Center (FQHC) · Jacksonville, FL

NPI number 1104259019 Active

Practice location

5150 Timuquana Rd, Suite 9
Jacksonville, FL 32210-8959

Call (904) 253-1120 Map

Fax (904) 253-2514

Mailing address

900 University Blvd N, MC-75
Jacksonville, FL 32211-9230

Specialties and licenses

TaxonomyCodeLicense
Federally Qualified Health Center (FQHC) Primary 261QF0400XNone listed

Federally Qualified Health Center (FQHC): Definition to come...

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About NPI 1104259019

Florida Department of Health's National Provider Identifier is 1104259019, issued on Aug 14, 2013. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Jacksonville, FL. The record was last updated on Aug 14, 2013.