MEDICARE: RIVERSIDE SPINE & PAIN PHYSICIANS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1124494398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERSIDE SPINE & PAIN PHYSICIANS, LLC

Provider Business Mailing Address
First Line	:	7207 GOLDEN WINGS RD
Second Line	:	SUITE 100
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-3324
Country	:	US
Telephone Number	:	904-389-1010
Fax Number	:	904-389-1082

Provider Business Practice Location Address
First Line	:	7740 POINT MEADOWS DR STE 6
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-9180
Country	:	US
Telephone Number	:	904-389-1010
Fax Number	:

Authorized Official
Title or Position	:	OFFICER AND AUTHORIZED OFFICAL
Name	:	JENNIFER BOYD BALDOCK
Credential	:
Telephone Number	:	615-234-5954

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	01/18/2023

Similar Medicare Providers

1023013281 — DR. WAYNE S. BARKER DDS, FACP
Practice Location Address:

7740 POINT MEADOWS DR , STE 4
JACKSONVILLE, FL
32256-9180

Practice Phone: 904-645-6457
Practice Fax: 904-645-6459

1811277288 — KATHERINE MICHELLE LANG AU. D
Practice Location Address:

7740 POINT MEADOWS DR STE 7
JACKSONVILLE, FL
32256-9180

Practice Phone: 904-202-6400
Practice Fax: 904-390-7383

1659760189 — FADEL TAAZIEH DPT, ATC
Practice Location Address:

7740 POINT MEADOWS DR STE 1 , CREDENTIALING DEPARTMENT
JACKSONVILLE, FL
32256-9180

Practice Phone: 904-564-9594
Practice Fax: 904-564-9687

1750831087 — MS. ROSE MARY JOHNSON D.D.S.
Practice Location Address:

7740 POINT MEADOWS DR STE 4
JACKSONVILLE, FL
32256-9180

Practice Phone: 720-467-9222
Practice Fax:

1922550177 — MEGAN C WEST AUD
Practice Location Address:

7740 POINT MEADOWS DR STE 7
JACKSONVILLE, FL
32256-9180

Practice Phone: 904-202-6400
Practice Fax: 904-390-7383

1386147551 — ANDREA LEIGH LYLES APRN
Practice Location Address:

7740 POINT MEADOWS DR STE 6
JACKSONVILLE, FL
32256-9180

Practice Phone: 904-389-1010
Practice Fax:

Directions to “RIVERSIDE SPINE & PAIN PHYSICIANS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.