| JM Garmendia MD PA | |
|
2636 Oak St Jacksonville FL 32204-4506 | |
| (904) 384-5553 | |
| (904) 384-2173 |
| Full Name | JM Garmendia MD PA |
|---|---|
| Speciality | Internal Medicine |
| Location | 2636 Oak St, Jacksonville, Florida |
| Authorized Official Name and Position | Jose Manuel Garmendia (PRESIDENT) |
| Authorized Official Contact | 9043845553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| JM Garmendia MD PA 2636 Oak St Jacksonville FL 32204-4506 Ph: (904) 384-5553 | JM Garmendia MD PA 2636 Oak St Jacksonville FL 32204-4506 Ph: (904) 384-5553 |
| NPI Number | 1497034912 |
|---|---|
| Provider Enumeration Date | 08/15/2011 |
| Last Update Date | 11/17/2011 |
| Medicare PECOS PAC ID | 3779752373 |
|---|---|
| Medicare Enrollment ID | O20110817000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497034912 | NPI | - | NPPES |
| 000516689A | Medicaid | GA | |
| 052375500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0053646 (Florida) | Primary |
| Provider Name | Jose M Garmendia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235173139 PECOS PAC ID: 7719156314 Enrollment ID: I20110817000296 |
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