| Complementary Care Center | |
|
1504 Roberts Dr Jacksonville Beach FL 32250-3222 | |
| (904) 247-7455 | |
| (904) 247-8550 |
| Full Name | Complementary Care Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1504 Roberts Dr, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Stephen E. Grable (PRESIDENT) |
| Authorized Official Contact | 9042477455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complementary Care Center 1504 Roberts Dr Jacksonville Beach FL 32250-3222 Ph: (904) 247-7455 | Complementary Care Center 1504 Roberts Dr Jacksonville Beach FL 32250-3222 Ph: (904) 247-7455 |
| NPI Number | 1245599497 |
|---|---|
| Provider Enumeration Date | 05/09/2012 |
| Last Update Date | 03/31/2017 |
| Medicare PECOS PAC ID | 1557647682 |
|---|---|
| Medicare Enrollment ID | O20170404000908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245599497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0056718 (Florida) | Primary |
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