| N E Florida Internal Medicine Pa | |
|
2065 Herschel St Jacksonville FL 32204-3817 | |
| (904) 387-4050 | |
| (904) 387-4860 |
| Full Name | N E Florida Internal Medicine Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2065 Herschel St, Jacksonville, Florida |
| Authorized Official Name and Position | Elyssa Blissenbach (PRESIDENT) |
| Authorized Official Contact | 9043874050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| N E Florida Internal Medicine Pa 2065 Herschel Street Jacksonville FL 32204-3817 Ph: (904) 387-4050 | N E Florida Internal Medicine Pa 2065 Herschel St Jacksonville FL 32204-3817 Ph: (904) 387-4050 |
| NPI Number | 1487724993 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 12/23/2010 |
| Medicare PECOS PAC ID | 6406947167 |
|---|---|
| Medicare Enrollment ID | O20070809000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487724993 | NPI | - | NPPES |
| 252461900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Monica Joset Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467432351 PECOS PAC ID: 8022090968 Enrollment ID: I20040603001018 |
| Provider Name | Elyssa Anne Blissenbach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881601714 PECOS PAC ID: 1759482318 Enrollment ID: I20070726000288 |
| Provider Name | Leah M Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336769934 PECOS PAC ID: 6002239209 Enrollment ID: I20200707000923 |
| Provider Name | Leaanne Griffis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649808197 PECOS PAC ID: 7315347705 Enrollment ID: I20210607000360 |
| Provider Name | Sara Elizabeth Haugen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770355596 PECOS PAC ID: 6901256841 Enrollment ID: I20231219001490 |
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