PHYSICAL HEALTHCARE OF JACKSONVILLE INC (NPI# 1760722011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760722011 |
| Entity Type | Organization |
| Organization Name | PHYSICAL HEALTHCARE OF JACKSONVILLE INC |
| Practice Address |
12620 Beach Blvd Suite 6 Jacksonville FL 32246-7131 |
| Practice Telephone | 9046450777 |
| Practice Fax Number | 9046453483 |
| Mailing Telephone | 9046450777 |
| Mailing Fax Number | 9046453483 |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2017-04-18 |
| Authorized Official Name | MARK A PIERCE (CLINIC DIRECTOR) |
| Authorized Official Telephone | 9046450777 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | CH6451 | FL | Chiropractic Providers |
| N | 111N00000X | Chiropractor | CH6588 | FL | Chiropractic Providers |
| N | 111N00000X | Chiropractor | CH4435 | FL | Chiropractic Providers |
| N | 208100000X | Physical Medicine & Rehabilitation | ME0060908 | FL | Allopathic & Osteopathic Physicians |
| N | 225100000X | Physical Therapist | PT30658 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | ME55161 | FL | Suppliers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9106788 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP 77074 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | ME0060908 | FL | Suppliers |
| Y | 207R00000X | Internal Medicine | ME55161 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
12620 BEACH BLVD SUITE 6 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32246-7131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748117 | David Richard Olinzock | Dentist | 12620 Beach Blvd, Ste 18, Jacksonville, FL 32246-7130 | 2005-05-24 |
| 1578173787 | Jennifer Plut | Acupuncturist | 12620 Beach Blvd, Jacksonville, FL 32246-7131 | 2020-08-03 |
| 1598211955 | Abigail Whitfield | Pharmacist | 12620 Beach Blvd, Suite 12, Jacksonville, FL 32246-7131 | 2016-08-26 |
| 1821467465 | Marissa Glinton | Pharmacist | 12620 Beach Blvd, Jacksonville, FL 32246-7131 | 2015-09-24 |
| 1225471873 | Irina Eugenievna Boldt | Family Medicine | 12620 Beach Blvd, Jacksonville, FL 32246-7131 | 2013-04-14 |
| 1538406236 | Dianne Chandler | Pharmacist | 12620 Beach Blvd, Jacksonville, FL 32246 | 2013-01-15 |
| 1083951909 | Megan Michelle Fadil | Pharmacist | 12620 Beach Blvd, Suite 12, Jacksonville, FL 32246-7130 | 2013-01-11 |
| 1982941118 | Sean H Klicker | Pharmacist | 12620 Beach Blvd, Suite 12, Jacksonville, FL 32246-7131 | 2013-01-08 |
| 1134409600 | Sean Francis Mchugh | Chiropractor | 12620 Beach Blvd, Suite 6, Jacksonville, FL 32246-7131 | 2011-08-27 |
| 1659663680 | Ogechukwu Umerah | Pharmacist | 12620 Beach Blvd, Jacksonville, FL 32246-7131 | 2011-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275179863 | Samar A Ibrahim | Pharmacist | 1305 N Orange Ave Green Cove Springs, Jacksonville, FL 32246 | 2019-11-19 |
| 1386290898 | Kelsey R Clevenger | Chiropractor | 4413 Town Center Parkway, Ste. 205, Jacksonville, FL 32246 | 2019-08-12 |
| 1700449006 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4712 Lake Center Drive, Space 107, Jacksonville, FL 32246 | 2019-04-22 |
| 1205399946 | Usa United Surgical Assistants | Clinic/Center | Bahri Surgical Center, 9726 Touchton Rd, Jacksonville, FL 32246 | 2019-04-10 |
| 1780173526 | Jules Novall LLC | Taxi | 4600 Touchton Rd, Jacksonville, FL 32246 | 2018-05-08 |
| 1740636307 | Jonathan David Browning | Psychiatry & Neurology | 4884 Deer Creek Drive W, Jacksonville, FL 32246 | 2016-05-12 |
| 1952770463 | Alignment Healthcare Florida LLC | Clinic/Center | 3520-1 St. Johns Bluff Rd., Jacksonville, FL 32246 | 2015-09-15 |
| 1558739417 | Jessica Brake | Physical Therapist | 9726 Touchton Road, Suite 104, Jacksonville, FL 32246 | 2015-09-09 |
| 1043686256 | Healthyeye Dba Vision Express LLC | Optometrist | 4871 Town Center Parkway #5, Jacksonville, FL 32246 | 2015-08-12 |
| 1477954675 | Joanivette Rodriguez | Psychologist | 3451 Saland Way Apt 504, Jacksonville, FL 32246 | 2014-09-08 |
| Find all providers in zip 32246 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004329 | Colin Craig Rowell | Internal Medicine | 4500 San Pablo Rd S Fl 32, Jacksonville, FL 32224-1865 | 2020-05-17 |
| 1457982977 | Ateeque Khan, Md P.a. | Internal Medicine | 3659 Eastbury Dr, Jacksonville, FL 32224-1659 | 2020-02-03 |
| 1013478221 | Naji Maaliki | Internal Medicine | 653-1 W 8th St Fl L184, Jacksonville, FL 32209-6511 | 2019-03-29 |
| 1770043259 | Fadi Kandah | Internal Medicine | 653-1 W 8th St # L15, Jacksonville, FL 32209-6511 | 2019-03-21 |
| 1346696002 | Alana Akers | Internal Medicine | 203 Nacogdoches St Ste 290, Jacksonville, TX 75766-2444 | 2016-05-11 |
| 1346602927 | Kevin Roy Green | Internal Medicine | 653-1 W 8th St # L18, Jacksonville, FL 32209-6511 | 2016-03-23 |
| 1093175770 | Alex Balmir | Internal Medicine | 655 W 8th St # Cc262, Jacksonville, FL 32209-6511 | 2016-02-24 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1316338957 | Deep Patel | Internal Medicine | 5238 Norwood Ave Ste 16, Jacksonville, FL 32208-5005 | 2015-02-17 |
| 1063801934 | Avecina Medical | Internal Medicine | 9580 Applecross Rd, 106, Jacksonville, FL 32222-5845 | 2015-01-15 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32246 |
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| 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.