| Caremax Clinic 711 Llc | |
|
2732 Trollie Ln Jacksonville FL 32211-3833 | |
| (904) 289-1254 | |
| Not Available |
| Full Name | Caremax Clinic 711 Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2732 Trollie Ln, Jacksonville, Florida |
| Authorized Official Name and Position | Vipul B Mamtora (DIRECTOR) |
| Authorized Official Contact | 9042891254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caremax Clinic 711 Llc Po Box 600365 Jacksonville FL 32260-0365 Ph: (904) 289-1254 | Caremax Clinic 711 Llc 2732 Trollie Ln Jacksonville FL 32211-3833 Ph: (904) 289-1254 |
| NPI Number | 1609359249 |
|---|---|
| Provider Enumeration Date | 09/10/2018 |
| Last Update Date | 06/06/2024 |
| Certification Date | 06/06/2024 |
| Medicare PECOS PAC ID | 3577806173 |
|---|---|
| Medicare Enrollment ID | O20190523000156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609359249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rashid I Saba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376612481 PECOS PAC ID: 9133177454 Enrollment ID: I20050104000370 |
| Provider Name | Bashir Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861466641 PECOS PAC ID: 7719918341 Enrollment ID: I20050824000157 |
| Provider Name | Mohammad Choudhary |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992037121 PECOS PAC ID: 6709041767 Enrollment ID: I20160510000291 |
| Provider Name | Dorothy Cassandra Meeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508498239 PECOS PAC ID: 2163853870 Enrollment ID: I20200513002460 |
| Provider Name | Latara Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316573173 PECOS PAC ID: 0446664866 Enrollment ID: I20210126003476 |
| Provider Name | Saijai Sonia Remy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417424458 PECOS PAC ID: 8729493630 Enrollment ID: I20210225002957 |
| Provider Name | Deekshita Damidi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598261984 PECOS PAC ID: 5698026813 Enrollment ID: I20210825000199 |
| Provider Name | Christelle Takou Oben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821341801 PECOS PAC ID: 6608266770 Enrollment ID: I20211203000577 |
| Provider Name | Hemangkumar Javaiya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952604464 PECOS PAC ID: 2668607805 Enrollment ID: I20220813000054 |
| Provider Name | Sylvia S Woodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700496262 PECOS PAC ID: 0244616829 Enrollment ID: I20221005001538 |
| Provider Name | Justin Michael Mortimer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013277656 PECOS PAC ID: 0941512495 Enrollment ID: I20231214002585 |
| Provider Name | Maryann Del Cid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497527865 PECOS PAC ID: 4880036169 Enrollment ID: I20240531002924 |
| Provider Name | Anotte Justilien Meriedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780402701 PECOS PAC ID: 6103356175 Enrollment ID: I20250205002918 |
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