Provider Demographics
NPI:1982276382
Name:UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC
Entity Type:Organization
Organization Name:UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
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:904-244-3592
Practice Address - Street 1:4555 EMERSON STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4958
Practice Address - Country:US
Practice Address - Phone:904-383-1010
Practice Address - Fax:904-383-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty