Provider Demographics
NPI:1740836048
Name:UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC
Entity type:Organization
Organization Name:UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDEY
Authorized Official - Middle Name:CLARKE
Authorized Official - Last Name:LANDKROHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-244-3603
Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3660
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:76011 WILLIAM BURGESS BLVD
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097
Practice Address - Country:US
Practice Address - Phone:904-427-8590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care