Provider Demographics
NPI:1942650593
Name:REBECCA FARINAS, M.D. LLC
Entity Type:Organization
Organization Name:REBECCA FARINAS, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-997-7776
Mailing Address - Street 1:7545 CENTURION PKWY
Mailing Address - Street 2:#302
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0579
Mailing Address - Country:US
Mailing Address - Phone:904-997-7776
Mailing Address - Fax:
Practice Address - Street 1:7545 CENTURION PKWY
Practice Address - Street 2:#302
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-0579
Practice Address - Country:US
Practice Address - Phone:904-997-7776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
FLME967942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2479333OtherCIGNA BEHAVIORAL HEALTH, INC.
FL600380OtherBEACON HEALTH OPTIONS (FORMERLY VALUE OPTIONS, INC.)
FL19352OtherTRICARE SOUTH BEHAVIORAL NETWORK
60054OtherAETNA