| Id Associates Of Jacksonville Pa | |
|
2 Shircliff Way Ste 610 Jacksonville FL 32204-4753 | |
| (904) 387-5027 | |
| (904) 387-2208 |
| Full Name | Id Associates Of Jacksonville Pa |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 2 Shircliff Way, Jacksonville, Florida |
| Authorized Official Name and Position | Jean-paul Montoya (OWNER) |
| Authorized Official Contact | 9043875027 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Associates Of Jacksonville Pa 2 Shircliff Way Ste 610 Jacksonville FL 32204-4753 Ph: (904) 387-5027 | Id Associates Of Jacksonville Pa 2 Shircliff Way Ste 610 Jacksonville FL 32204-4753 Ph: (904) 387-5027 |
| NPI Number | 1013107077 |
|---|---|
| Provider Enumeration Date | 07/26/2007 |
| Last Update Date | 07/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013107077 | NPI | - | NPPES |
| 001362900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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