1265229918 NPI number — NORTH FLORIDA SURGEONS, PA

Table of content: (NPI 1265229918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265229918 NPI number — NORTH FLORIDA SURGEONS, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH FLORIDA SURGEONS, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265229918
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11945 SAN JOSE BLVD STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32223-1627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-396-1725
Provider Business Mailing Address Fax Number:
904-396-4893

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14534 OLD ST. AUGUSTINE RD
Provider Second Line Business Practice Location Address:
SUITE 3210
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-880-1260
Provider Business Practice Location Address Fax Number:
904-880-1210
Provider Enumeration Date:
04/24/2025

Additional Information

Authorized Official

Authorized Official Last Name:
BERLIN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
904-396-1725

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com