Physical Healthcare Of Jacksonville Inc is a medicare enrolled "Internal Medicine" provider in Jacksonville, Florida. Their current practice location is
12620 Beach Blvd, Suite 6, Jacksonville, Florida. You can reach out to their office (for appointments etc.) via phone at
(904) 645-0777.
Physical Healthcare Of Jacksonville Inc is licensed to practice in Florida (license number ME55161) and it also participates in the medicare program. Physical Healthcare Of Jacksonville Inc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1760722011.
Healthcare Provider's Profile
| Full Name | Physical Healthcare Of Jacksonville Inc |
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| Type | Facility |
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| Speciality | Internal Medicine |
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| Location | 12620 Beach Blvd, Jacksonville, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1760722011
- Provider Enumeration Date: 02/25/2013
- Last Update Date: 04/18/2017
Medicare PECOS Information:
- PECOS PAC ID: 9234376690
- Enrollment ID: O20130503000012
Medical Identifiers
Medical identifiers for Physical Healthcare Of Jacksonville Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760722011 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | CH6451 (Florida) | Secondary |
| 111N00000X | Chiropractor | CH6588 (Florida) | Secondary |
| 111N00000X | Chiropractor | CH4435 (Florida) | Secondary |
| 207R00000X | Internal Medicine | ME55161 (Florida) | Primary |
| 208100000X | Physical Medicine & Rehabilitation | ME0060908 (Florida) | Secondary |
| 225100000X | Physical Therapist | PT30658 (Florida) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | ME0060908 (Florida) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | ME55161 (Florida) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA9106788 (Florida) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | ARNP 770742 (Florida) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Physical Healthcare Of Jacksonville Inc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Physical Healthcare Of Jacksonville Inc
12620 Beach Blvd, Suite 6,
Jacksonville, FL 32246-7131
Ph: (904) 645-0777 | Physical Healthcare Of Jacksonville Inc
12620 Beach Blvd, Suite 6,
Jacksonville, FL 32246-7131
Ph: (904) 645-0777 |
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