| Jacksonville Heights Medical Services | |
|
7450 103rd St Jacksonville FL 32210-6780 | |
| (904) 778-3315 | |
| (904) 778-3314 |
| Full Name | Jacksonville Heights Medical Services |
|---|---|
| Speciality | Family Medicine |
| Location | 7450 103rd St, Jacksonville, Florida |
| Authorized Official Name and Position | Mel Carbonell (PRESIDENT) |
| Authorized Official Contact | 9047783315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacksonville Heights Medical Services 7450 103rd St Jacksonville FL 32210-6780 Ph: (904) 778-3315 | Jacksonville Heights Medical Services 7450 103rd St Jacksonville FL 32210-6780 Ph: (904) 778-3315 |
| NPI Number | 1922302074 |
|---|---|
| Provider Enumeration Date | 01/04/2011 |
| Last Update Date | 01/04/2011 |
| Medicare PECOS PAC ID | 5496937468 |
|---|---|
| Medicare Enrollment ID | O20110311000625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922302074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Florida) | Primary |
| Provider Name | Melchor Carbonell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417027566 PECOS PAC ID: 0446432421 Enrollment ID: I20110311000699 |
| Provider Name | Liza R Byatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881239721 PECOS PAC ID: 6002243680 Enrollment ID: I20200220000359 |
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