Provider Demographics
NPI:1962660399
Name:DOCTORS CHOICE JACKSONVILLE LLC
Entity Type:Organization
Organization Name:DOCTORS CHOICE JACKSONVILLE LLC
Other - Org Name:ACCENTCARE HOME HEALTH OF JACKSONVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-201-3819
Mailing Address - Street 1:1542 KINGSLEY AVE STE 131&132
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4586
Mailing Address - Country:US
Mailing Address - Phone:904-269-6868
Mailing Address - Fax:904-269-9898
Practice Address - Street 1:1542 KINGSLEY AVE
Practice Address - Street 2:STE 131/132
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4587
Practice Address - Country:US
Practice Address - Phone:904-269-6868
Practice Address - Fax:904-269-9898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991611251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107725Medicare PIN