Provider Demographics
NPI:1750516506
Name:NATIONAL MANAGED CARE SOLUTIONS, LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:NATIONAL MANAGED CARE SOLUTIONS, LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-398-2010
Mailing Address - Street 1:9570 REGENCY SQUARE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-9103
Mailing Address - Country:US
Mailing Address - Phone:904-638-2650
Mailing Address - Fax:
Practice Address - Street 1:819 TOWNSEND BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-6132
Practice Address - Country:US
Practice Address - Phone:904-551-7595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty