Unknown Individual – Internal Medicine Physician, NPI 1356336846
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 61148
JACKSONVILLE, FL 322361148
Phone: (904) 308-3696
Fax: (904) 308-3697
Type: Mailing
3627, University Boulevard South, Englewood, Jacksonville, Duval County, Florida, 32216, United States
SUITE 415
JACKSONVILLE, FL 322164230
Phone: (904) 398-5123
Fax: (904) 398-9157
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32236)
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