Provider Demographics
NPI:1285680231
Name:JACKSONVILLE HAND ASSOCIATES P.A.
Entity Type:Organization
Organization Name:JACKSONVILLE HAND ASSOCIATES P.A.
Other - Org Name:JACKSONVILLE HAND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:SPRUILL
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-262-8442
Mailing Address - Street 1:14546 SAINT AUGUSTINE RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5468
Mailing Address - Country:US
Mailing Address - Phone:904-262-8442
Mailing Address - Fax:904-262-8482
Practice Address - Street 1:14546 SAINT AUGUSTINE RD
Practice Address - Street 2:SUITE 405
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5468
Practice Address - Country:US
Practice Address - Phone:904-262-8442
Practice Address - Fax:904-262-8482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46416174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15992Medicare ID - Type Unspecified
FLD61847Medicare UPIN