| First Coast Family Medicine Pa | |
|
9130 Rg Skinner Parkway Jacksonville FL 32256 | |
| (904) 538-0950 | |
| (904) 538-0952 |
| Full Name | First Coast Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 9130 Rg Skinner Parkway, Jacksonville, Florida |
| Authorized Official Name and Position | Terry D Hashey (OWNER) |
| Authorized Official Contact | 9045380950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Coast Family Medicine Pa 9130 Rg Skinner Pkwy Jacksonville FL 32256 Ph: (904) 538-0950 | First Coast Family Medicine Pa 9130 Rg Skinner Parkway Jacksonville FL 32256 Ph: (904) 538-0950 |
| NPI Number | 1558457341 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 09/28/2023 |
| Medicare PECOS PAC ID | 4880791375 |
|---|---|
| Medicare Enrollment ID | O20070517000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558457341 | NPI | - | NPPES |
| AC476 | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS 9368 (Florida) | Primary |
| Provider Name | Terry Hashey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003899303 PECOS PAC ID: 8426155912 Enrollment ID: I20070717000186 |
| Provider Name | Diana C Maccario |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205007036 PECOS PAC ID: 5799826905 Enrollment ID: I20100111000365 |
| Provider Name | Harry T Madhanagopal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740568278 PECOS PAC ID: 5890928899 Enrollment ID: I20181019002151 |
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