Provider Demographics
NPI:1790770873
Name:NORTH FLORIDA MEDICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:NORTH FLORIDA MEDICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:SAIKALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-733-3992
Mailing Address - Street 1:PO BOX 160817
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32716-0817
Mailing Address - Country:US
Mailing Address - Phone:904-886-5385
Mailing Address - Fax:
Practice Address - Street 1:4131 UNIVERSITY BLVD S
Practice Address - Street 2:#8
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4326
Practice Address - Country:US
Practice Address - Phone:904-733-3992
Practice Address - Fax:904-737-4344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS3216207Q00000X
FLME51890207R00000X
FLME0047248207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271610100Medicaid
FL271610100Medicaid