| The Doctors Center Inc | |
|
9857 Old Saint Augustine Rd Ste 1 Jacksonville FL 32257-8821 | |
| (904) 861-1900 | |
| (904) 292-9684 |
| Full Name | The Doctors Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 9857 Old Saint Augustine Rd Ste 1, Jacksonville, Florida |
| Authorized Official Name and Position | Majed Hassan (OWNER) |
| Authorized Official Contact | 9048611900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Doctors Center Inc 9857 Old Saint Augustine Rd Ste 1 Jacksonville FL 32257-8821 Ph: (904) 861-1900 | The Doctors Center Inc 9857 Old Saint Augustine Rd Ste 1 Jacksonville FL 32257-8821 Ph: (904) 861-1900 |
| NPI Number | 1053366880 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 08/02/2022 |
| Medicare PECOS PAC ID | 9133020787 |
|---|---|
| Medicare Enrollment ID | O20040116000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053366880 | NPI | - | NPPES |
| 39739 | Other | FL | BLUE CROSS BLUE SHIELD |
| 1018488 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Ernesto L Izquierdo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629182662 PECOS PAC ID: 0547260127 Enrollment ID: I20070104000288 |
| Provider Name | Jesus M Logronio |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437244571 PECOS PAC ID: 0345242244 Enrollment ID: I20070206000366 |
| Provider Name | Allen Okie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255394896 PECOS PAC ID: 7214052323 Enrollment ID: I20100913001102 |
| Provider Name | Majed Boulos Hassan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366599540 PECOS PAC ID: 5698676252 Enrollment ID: I20130214000192 |
| Provider Name | Grace Merchant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780737197 PECOS PAC ID: 8325091135 Enrollment ID: I20130423000333 |
| Provider Name | Sam N Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265859516 PECOS PAC ID: 5193943884 Enrollment ID: I20140821000720 |
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