| Impact 13 Medical, Pllc | |
|
10752 Deerwood Park Blvd South Waterview Ii Suite 100 Jacksonville FL 32256 | |
| (904) 755-1017 | |
| (646) 774-0386 |
| Full Name | Impact 13 Medical, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 10752 Deerwood Park Blvd, Jacksonville, Florida |
| Authorized Official Name and Position | Wil E Germain (OWNER) |
| Authorized Official Contact | 5164121608 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact 13 Medical, Pllc 10752 Deerwood Park Blvd South Waterview Ii Suite 100 Jacksonville FL 32256-8666 Ph: (904) 755-1017 | Impact 13 Medical, Pllc 10752 Deerwood Park Blvd South Waterview Ii Suite 100 Jacksonville FL 32256 Ph: (904) 755-1017 |
| NPI Number | 1548805617 |
|---|---|
| Provider Enumeration Date | 11/13/2019 |
| Last Update Date | 12/18/2019 |
| Certification Date | 12/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548805617 | NPI | - | NPPES |
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