Unknown Individual – Emergency Medicine Physician, NPI 1679591796
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Prudential Drive, Jacksonville, Duval County, Florida, 32202, United States
JACKSONVILLE, FL 322078209
Phone: (904) 396-5682
Fax: (904) 346-0864
Type: Mailing
Baptist Medical Center Nassau, 1250, South 18th Street, Fernandina Beach, Nassau County, Florida, 32034, United States
FERNANDINA BEACH, FL 320341902
Phone: (904) 396-5682
Fax: (904) 346-0864
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 ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32207)
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