Provider Demographics
NPI:1508894791
Name:PHYSICIANS HEALTHCARE AUTOMATION INC
Entity Type:Organization
Organization Name:PHYSICIANS HEALTHCARE AUTOMATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-281-0944
Mailing Address - Street 1:PO BOX 1454
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32004-1454
Mailing Address - Country:US
Mailing Address - Phone:904-281-0944
Mailing Address - Fax:904-281-9806
Practice Address - Street 1:BAPTIST MEDICAL CENTER
Practice Address - Street 2:800 PRUDENTIAL DR
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32232
Practice Address - Country:US
Practice Address - Phone:904-202-2092
Practice Address - Fax:908-281-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74033174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6139Medicare ID - Type Unspecified