SURGCENTER OF GREATER JACKSONVILLE, LLC (NPI# 1104485440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104485440 |
| Entity Type | Organization |
| Organization Name | SURGCENTER OF GREATER JACKSONVILLE, LLC |
| Practice Address |
9143 Philips Hwy Ste 500 Jacksonville FL 32256-1335 |
| Mailing Address |
692 Chestwood Chase Dr Orange Park FL 32065-2572 |
| Practice Telephone | 9042330597 |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | JEFFREY BURNETTE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4787194096 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
9143 PHILIPS HWY STE 500 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-1335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1366982845 | Jacksonville Endoscopy Centers LLC | Clinic/Center | 1610 Barrs St Ste B, Jacksonville, FL 32204-4569 | 2017-03-02 |
| 1952771602 | Andrews Surgery Center At Jacksonville Medplex LLC | Clinic/Center | 9726 Touchton Road, Jacksonville, FL 32246-8227 | 2015-10-06 |
| 1770620742 | Samuel Wells Surgicenter Inc | Clinic/Center | 3599 University Blvd S Ste 604, Jacksonville, FL 32216-4234 | 2007-01-31 |
| 1093772667 | Medical Partners Surgery Center LLC | Clinic/Center | 4545 Emerson Expressway, Jacksonville, FL 32207-4918 | 2006-04-27 |
| 1215990627 | Westside Surgery Center Ltd | Clinic/Center | 2731 Park St, Jacksonville, FL 32205-7607 | 2006-04-07 |
| 1134182546 | Jacksonville Surgery Center, Ltd | Clinic/Center | 7021 A C Skinner Pkwy, Jacksonville, FL 32256-6932 | 2006-04-07 |
| 1588633481 | Bgc Holdings Inc | Clinic/Center | 1610 Barrs St, Jacksonville, FL 32204-4569 | 2006-03-15 |
| 1922085059 | Asc North LLP | Clinic/Center | 590 Dundas Dr, Jacksonville, FL 32218-5579 | 2005-12-29 |
| 1528579034 | Ambulatory Care Specialists of Jacksonville LLC | Clinic/Center | 6820 Southpoint Pkwy, Jacksonville, FL 32216 | 2017-10-24 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
Please comment or provide details below to improve the information on SURGCENTER OF GREATER JACKSONVILLE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.