MAYO CLINIC JACKSONVILLE (NPI# 1265097513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265097513 |
| Entity Type | Organization |
| Organization Name | MAYO CLINIC JACKSONVILLE |
| Other Organization Name | MAYO CLINIC JACKSONVILLE MEDICAL TRANSPORT |
| Practice Address |
13970 Zumbro Dr Jacksonville FL 32224 |
| Mailing Address |
4500 San Pablo Rd S Jacksonville FL 32224-1865 |
| Practice Telephone | 9049532000 |
| Mailing Telephone | 9049532000 |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-08-29 |
| Authorized Official Name | KEVIN MICHAEL LOCKETT (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9049532939 |
| Is Organization Subpart | Y |
| Parent Organization Name | MAYO CLINIC JACKSONVILLE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
| Other Name | Type Code |
|---|---|
| Mayo Clinic Jacksonville Medical Transport | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578037891 | Mayo Clinic Jacksonville | Durable Medical Equipment & Medical Supplies | 7826 Ozark Dr, Jacksonville, FL 32256-5839 | 2019-01-21 |
| 1790772317 | Mayo Clinic Jacksonville | Durable Medical Equipment & Medical Supplies | 4500 San Pablo Road, Jacksonville, FL 32224-1865 | 2005-09-29 |
| 1174143986 | Mayo Clinic Jacksonville | Clinic/Center | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-04-22 |
| 1871054106 | Mayo Clinic Jacksonville | Clinic/Center | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2019-03-28 |
| 1558350413 | Mayo Clinic Jacksonville | Pharmacy | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-10-13 |
| 1962499079 | Mayo Clinic Jacksonville | Clinic/Center | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-10-04 |
| 1285621631 | Mayo Clinic Jacksonville | Clinical Medical Laboratory | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-09-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAYO CLINIC JACKSONVILLE (A NONPROFIT CORPORATION) | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 |
| Street Address |
13970 ZUMBRO DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| 1679821656 | Hope Jessecca Gunn | Clinical Nurse Specialist | Unf/s Hs 1 Unf Drive Building 39a, Jacksonville, FL 32224 | 2012-08-22 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568008977 | Ameripro Ems of Florida, LLC | Ambulance | 4810 Executive Park Ct Ste 112, Jacksonville, FL 32216-6018 | 2019-11-20 |
| 1841763984 | Kindred Care Ems LLC | Ambulance | 6824 Norwood Ave, Jacksonville, FL 32208-4471 | 2019-01-10 |
| 1477942050 | Jax Patient Care | Ambulance | 100 Wharfside Way # A, Jacksonville, FL 32207-8104 | 2015-01-20 |
| 1245488857 | Village of South Jacksonville | Ambulance | 301 Dewey Dr, Jacksonville, IL 62650-3206 | 2008-09-08 |
| 1013070382 | Herbert Steven Pridgen | Ambulance | 705 Grants Creek Rd, Jacksonville, NC 28546-9644 | 2006-12-18 |
| 1679662886 | Ambulance Service, Inc. | Ambulance | 5995 Philips Hwy, Jacksonville, FL 32216-5916 | 2006-10-12 |
| 1720027147 | County of Onslow | Ambulance | 1180 Commons Dr N, Jacksonville, NC 28546-6965 | 2006-06-05 |
| 1932153335 | Century Ambulance Service, Inc. | Ambulance | 2110 Herschel St, Jacksonville, FL 32204-3820 | 2006-05-20 |
| 1902895055 | City of Jacksonville | Ambulance | 900 N Redmond Rd, Jacksonville, AR 72076-3623 | 2005-10-20 |
| 1730188673 | City of Jacksonville | Ambulance | 506 Chinabee Ave Se, Jacksonville, AL 36265-2881 | 2005-07-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
Please comment or provide details below to improve the information on MAYO CLINIC JACKSONVILLE.
| 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.