JACKSONVILLE INTERNAL MEDICINE & WELLNESS LLC (NPI# 1679011969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679011969 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE INTERNAL MEDICINE & WELLNESS LLC |
| Practice Address |
1701 Pelham Rd S Jacksonville AL 36265-3353 |
| Practice Telephone | 2563652416 |
| Practice Fax Number | 2563652426 |
| Mailing Telephone | 2563652412 |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-03-02 |
| Authorized Official Name | EDUARDO VILLEDA (OWNER) |
| Authorized Official Telephone | 9176847325 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | AL | Other Service Providers |
| Street Address |
1701 PELHAM RD S |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265-3353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508824764 | William Ernest Tyndall | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2006-05-03 |
| 1427503010 | The Health Care Authority of The City of Anniston | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2016-08-24 |
| 1982058392 | Christina Joy Latta | Nurse Practitioner | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2016-04-21 |
| 1316312028 | Jacksonville Aristo Er, LLC | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2015-12-07 |
| 1235575622 | Stoney Brook Emergency Physicians, Pllc | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2013-05-13 |
| 1285971895 | Timothy B Tabor Md PC | Radiology | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2013-01-16 |
| 1942506852 | Physician Services of Alabama LLC | Specialist | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2011-02-10 |
| 1285945832 | Wade Bilger | Nurse Anesthetist, Certified Registered | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2010-06-29 |
| 1205165065 | Jacksonville Anesthesia LLC | Anesthesiology | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2009-12-08 |
| 1023253762 | Jacksonville Emergency Physicians LLC | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2008-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518011972 | Dennis Stone | Legal Medicine | 3408 State Road 13, Jacksonville, FL 32259-9270 | 2007-01-23 |
| 1609933514 | Ladiga Medical, LLC | Legal Medicine | 1460 2nd Ave Sw # A, Jacksonville, AL 36265-3358 | 2007-01-02 |
| 1396952784 | Progressive Pediatrics,llc | Legal Medicine | 1539 Parental Home Rd, Jacksonville, FL 32216-3009 | 2007-05-17 |
| 1386723005 | Independent Pediatricians of North Fl Inc | Legal Medicine | 4051 Atlantic Blvd, Jacksonville, FL 32207-2036 | 2006-11-03 |
| 1033128152 | Ernst Nicolitz Md Pa | Legal Medicine | 7051 Southpoint Pkwy, 3rd Floor, Jacksonville, FL 32216-8709 | 2006-08-07 |
| 1225068513 | Lourdes Carolina Ceron-canas | Legal Medicine | 1539 Parental Home Rd, Jacksonville, FL 32216 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669919650 | Dr James H Blanton Md | Legal Medicine | 4453 Fredericksburg Cir, Mountain Brk, AL 35213-1817 | 2017-01-27 |
| 1679969927 | Walter Miller White | Legal Medicine | 4209 Old Leeds Ln, Mountain Brk, AL 35213-3313 | 2015-04-14 |
| 1770905200 | James Jackson | Legal Medicine | 1404 Chandler Rd Se, Huntsville, AL 35801-1406 | 2014-01-17 |
| 1053623264 | John R. Boname | Legal Medicine | 4657 Old Looney Mill Rd, Birmingham, AL 35243-2640 | 2010-07-06 |
| 1154497105 | Family Practice Associates of Montrose, Pa | Legal Medicine | 770 Middle St Ste B, Fairhope, AL 36532-1766 | 2006-11-28 |
| 1144301128 | Staff of Life Medical Corporation, PC | Legal Medicine | 1011 Leighton Ave, Anniston, AL 36207-5701 | 2006-10-18 |
| 1275641425 | Ostap Woloschuk | Legal Medicine | 604 Gandy St Ne, Russellville, AL 35653-1912 | 2006-08-28 |
| 1841209020 | Medicine Beyond Walls | Legal Medicine | 6291 Letson Farms Dr, Bessemer, AL 35022-7025 | 2006-08-05 |
| 1992723019 | Gary R Newsom | Legal Medicine | 701 University Blvd E Ste 204, Tuscaloosa, AL 35401-7431 | 2006-07-17 |
| 1942240445 | Manuel Pouparinas | Legal Medicine | 1237 Deborah Dr Se, Huntsville, AL 35801-1414 | 2006-06-07 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
Please comment or provide details below to improve the information on JACKSONVILLE INTERNAL MEDICINE & WELLNESS 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.